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Primary Care Transformation

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https://www.readbyqxmd.com/read/29449896/myxofibrosarcoma-primary-cultures-molecular-and-pharmacological-profile
#1
Alessandro De Vita, Federica Recine, Laura Mercatali, Giacomo Miserocchi, Chiara Liverani, Chiara Spadazzi, Roberto Casadei, Alberto Bongiovanni, Federica Pieri, Nada Riva, Dino Amadori, Toni Ibrahim
Background: Myxofibrosarcoma (MFS), formerly considered as a myxoid variant of malignant fibrous histiocytoma, is the most common sarcoma of the extremities in adults and is characterized by a high frequency of local recurrence. The clinical behavior of MFS is unpredictable and the efficacy of chemotherapy is still not well documented. Furthermore, given the relatively recent recognition of MFS as a distinct pathologic entity its cellular and molecular biology has still not been extensively studied in patient-derived preclinical models...
December 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29441567/water-fluoridation-and-the-quality-of-information-available-online
#2
Zachary Frangos, Maryke Steffens, Julie Leask
BACKGROUND: The Internet has transformed the way in which people approach their health care, with online resources becoming a primary source of health information. Little work has assessed the quality of online information regarding community water fluoridation. This study sought to assess the information available to individuals searching online for information, with emphasis on the credibility and quality of websites. METHODS: We identified the top 10 web pages returned from different search engines, using common fluoridation search terms (identified in Google Trends)...
February 13, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29422946/evaluating-the-communities-care-program-best-practice-for-rigorous-research-to-evaluate-gender-based-violence-prevention-and-response-programs-in-humanitarian-settings
#3
N Glass, N Perrin, A Clough, A Desgroppes, F N Kaburu, J Melton, A Rink, S Read-Hamilton, M Marsh
Background: Gender-based violence (GBV) is a significant issue for women and girls in humanitarian settings. Innovative primary prevention programs are being developed and implemented with existing response programs to change harmful social norms that sustain GBV in humanitarian settings. Social norms are expectations of how women, men, girls and boys should behave, who should have power and control over behavior, and how families and communities value women and girls and support their rights and opportunities...
2018: Conflict and Health
https://www.readbyqxmd.com/read/29404850/mabal-a-novel-deep-learning-architecture-for-machine-assisted-bone-age-labeling
#4
Simukayi Mutasa, Peter D Chang, Carrie Ruzal-Shapiro, Rama Ayyala
Bone age assessment (BAA) is a commonly performed diagnostic study in pediatric radiology to assess skeletal maturity. The most commonly utilized method for assessment of BAA is the Greulich and Pyle method (Pediatr Radiol 46.9:1269-1274, 2016; Arch Dis Child 81.2:172-173, 1999) atlas. The evaluation of BAA can be a tedious and time-consuming process for the radiologist. As such, several computer-assisted detection/diagnosis (CAD) methods have been proposed for automation of BAA. Classical CAD tools have traditionally relied on hard-coded algorithmic features for BAA which suffer from a variety of drawbacks...
February 5, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29402103/proposal-of-a-new-public-health-end-of-life-approach-for-brazil-how-the-project-estaraoseulado-primary-palliative-care-is-working-and-how-it-can-help
#5
Santiago Corrêa
Brazil has 206 million people, and 1.2 million deaths and 600,000 new cases of cancer per year. Palliative Care services are patchily distributed. The Family Health Strategy, made up from 41,000 primary care teams across Brazil forms a comprehensive primary care network. The Project EstaraoSeuLado-Primary Palliative Care developed working from Community Centers. We created a model based on compassionate communities, with community carers working alongside primary care teams. We identified people who need palliative care, gave them specific care and enrolled their carers into a program of monthly meetings called "Comunidade Cuidador"...
January 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29401127/gender-affirmation-surgery-a-synopsis-using-american-college-of-surgeons-national-surgery-quality-improvement-program-and-national-inpatient-sample-databases
#6
Bao Ngoc N Tran, Sherise Epstein, Dhruv Singhal, Bernard T Lee, Adam M Tobias, Oren Ganor
BACKGROUND: Gender affirmation surgery (GAS) is a heterogeneous group of body transformational procedures to match one's gender identity. There is a paucity of literature on the outcomes and safety profile of GAS. This study aims to examine trends and outcomes of GAS from 2010 to 2015 using the American College of Surgeons National Surgery Quality Improvement Program and National Inpatient Sample databases. METHODS: Patients with a primary diagnosis of gender dysphoria at the time of surgery were identified in both databases...
February 2, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29401031/data-driven-diffusion-of-innovations-successes-and-challenges-in-3-large-scale-innovative-delivery-models
#7
David A Dorr, Deborah J Cohen, Julia Adler-Milstein
Failed diffusion of innovations may be linked to an inability to use and apply data, information, and knowledge to change perceptions of current practice and motivate change. Using qualitative and quantitative data from three large-scale health care delivery innovations-accountable care organizations, advanced primary care practice, and EvidenceNOW-we assessed where data-driven innovation is occurring and where challenges lie. We found that implementation of some technological components of innovation (for example, electronic health records) has occurred among health care organizations, but core functions needed to use data to drive innovation are lacking...
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29397766/trends-in-discharges-from-the-hiv-aids-ward-at-a-tertiary-canadian-hospital-from-2005-to-2014
#8
Denise Jaworsky, Peter Phillips, Zishan Cui, William Chau, Guillaume Colley, Raja Dutta, Benita Yip, Hayden Kremer, Oghenowede Eyawo, Julio Sg Montaner, Mark W Hull
Advances in HIV therapies have transformed HIV infection into a manageable chronic disease. Accordingly, hospital admission trends among people living with HIV may have evolved over time. This study describes discharge diagnoses from the dedicated HIV/AIDS ward at St. Paul's Hospital in Vancouver, Canada. A retrospective database review of admissions to the HIV/AIDS ward between 1 July 2005 and 30 June 2014 was conducted. Primary discharge diagnoses were manually categorized by condition and reviewed by two physicians...
February 4, 2018: AIDS Care
https://www.readbyqxmd.com/read/29390446/hepatic-angiosarcomatous-transformation-of-a-mediastinal-germinal-cell-tumor-a-care-case-report
#9
Giuseppe Corrias, Joanna G Escalon, Laura Tang, Serena Monti, Luca Saba, Lorenzo Mannelli
RATIONALE: Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare. PATIENT CONCERNS: We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness. DIAGNOSES: The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384752/curricular-transformation-the-case-against-global-change
#10
Jeffrey M Borkan, Paul George, Allan R Tunkel
In this Commentary, the authors make the case for medical schools to pursue more circumscribed solutions to curricular redesign for undergraduate medical education (UME) rather than whole system changes-at least as first steps and perhaps as ultimate solutions. While they focus primarily on the experience at the Warren Alpert Medical School of Brown University (AMS), they believe that the insights gleaned from their experiences are generalizable to other innovations and other medical schools. The authors describe the implementation of the Primary Care - Population Medicine track at AMS as a working example of implementing circumscribed rather than global change, and they discuss the advantages and disadvantages of such an approach to curriculum transformation...
January 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29370768/cost-effectiveness-of-increasing-vaccination-in-high-risk-adults-aged-18-64%C3%A2-years-a-model-based-decision-analysis
#11
Angela R Wateska, Mary Patricia Nowalk, Richard K Zimmerman, Kenneth J Smith, Chyongchiou J Lin
BACKGROUND: Adults aged 18-64 years with comorbid conditions are at high risk for complications of certain vaccine-preventable diseases, including influenza and pneumococcal disease. The 4 Pillars™ Practice Transformation Program (4 Pillars Program) increases uptake of pneumococcal polysaccharide vaccine, influenza vaccine and tetanus-diphtheria-acellular pertussis vaccine by 5-10% among adults with high-risk medical conditions, but its cost-effectiveness is unknown. METHODS: A decision tree model estimated the cost-effectiveness of implementing the 4 Pillars Program in primary care practices compared to no program for a population of adults 18-64 years of age at high risk of illness complications over a 10 year time horizon...
January 25, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29369797/estimating-summary-statistics-for-electronic-health-record-laboratory-data-for-use-in-high-throughput-phenotyping-algorithms
#12
D J Albers, N Elhadad, J Claassen, R Perotte, A Goldstein, G Hripcsak
We study the question of how to represent or summarize raw laboratory data taken from an electronic health record (EHR) using parametric model selection to reduce or cope with biases induced through clinical care. It has been previously demonstrated that the health care process [1,2], as defined by measurement context[2,3] and measurement patterns [4,5], can influence how EHR data are distributed statistically [6,7]. We construct an algorithm, PopKLD, which is based on information criterion model selection [8,9], is intended to reduce and cope with health care process biases and to produce an intuitively understandable continuous summary...
January 21, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29368673/analysis-of-postdischarge-costs-following-emergent-general-surgery-in-elderly-patients
#13
Gilgamesh J Eamer, Fiona Clement, Jenelle L Pederson, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: As populations age, more elderly patients will undergo surgery. Frailty and complications are considered to increase in-hospital cost in older adults, but little is known on costs following discharge, particularly those borne by the patient. We examined risk factors for increased cost and the type of costs accrued following discharge in elderly surgical patients. METHODS: Acute abdominal surgery patients aged 65 years and older were prospectively enrolled...
February 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29343253/an-integrated-primary-care-approach-for-frail-community-dwelling-older-persons-a-step-forward-in-improving-the-quality-of-care
#14
Lotte Vestjens, Jane M Cramm, Anna P Nieboer
BACKGROUND: High-quality care delivery for frail older persons, many of whom have multiple complex needs, is among the greatest challenges faced by healthcare systems today. The Chronic Care Model (CCM) may guide quality improvement efforts for primary care delivery to frail older populations. Objectives of this study were to assess the implementation of interventions in CCM dimensions, and to investigate the quality of primary care as perceived by healthcare professionals, in practices following the Finding and Follow-up of Frail older persons (FFF) integrated care approach and those providing usual care...
January 17, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29343156/patient-contributions-during-primary-care-consultations-for-hypertension-after-self-reporting-via-a-mobile-phone-self-management-support-system
#15
Ulrika Bengtsson, Karin Kjellgren, Inger Hallberg, Mona Lundin, Åsa Mäkitalo
OBJECTIVE: This paper reports on how the clinical consultation in primary care is performed under the new premises of patients' daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients' contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. DESIGN: A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis...
January 18, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29329792/-implementation-of-a-health-promotion-programme-for-women-in-social-exclusion-in-the-city-of-seville-spain
#16
Cristina Rodríguez Fernández-Viagas, Carmen García Gil, Nora Bayo Barroso, Cristina Villalba Quesada, Manuela Álvarez Girón
Health promotion can contribute towards reducing inequality and ensuring equal opportunities, providing the means to enable the entire population to develop its maximum health possibilities. Women living in areas with social transformation needs (ASTN) are an especially vulnerable group due to the situation of material deprivation and social exclusion in which they live. Health promotion programmes for this group can bring about an improvement in their health. This paper describes the health promotion programme Socio-educational Groups of Primary Care for Women (SEGPC-W), and evaluates its implementation in ASTN in the city of Seville (Spain), as well as the benefits and difficulties of its development through a documentary analysis and interviews with participating professionals...
January 9, 2018: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29318218/potential-benefit-associated-with-delaying-initiation-of-hemodialysis-in-a-japanese-cohort
#17
Satoshi Higuchi, Izaya Nakaya, Kazuhiro Yoshikawa, Yoichiro Chikamatsu, Ken-Ei Sada, Suguru Yamamoto, Satoko Takahashi, Hiroyo Sasaki, Jun Soma
Introduction: Late referral to a nephrologist, the type of vascular access, nutritional status, and the estimated glomerular filtration rate (eGFR) at the start of hemodialysis (HD) have been reported as independent risk factors of survival for patients who begin HD. The aim of this study was to clarify the influence of the HD-free interval from the time of an eGFR of 10 ml/min per 1.73 m2 (IGFR10-HD) on patient outcome. Methods: We enrolled 124 patients aged older than 20 years who had HD initiated in a general hospital...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#18
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29306971/trauma-care-in-german-speaking-countries-have-changes-in-the-curricula-led-to-changes-in-practice-after-10%C3%A2-years
#19
Sarah Kuhn-Régnier, Michael Stickel, Björn-Christian Link, Henning Fischer, Reto Babst, Frank J P Beeres
PURPOSE: Traditionally, in the German-speaking countries, trauma patients are treated by general surgeons specialized in trauma surgery known as the Unfallchirurg. Over the last decade, a trend towards a lower influence of surgeons and a higher influence of subspecialties in the emergency department has been noted. With additional transformations in the health care system towards highly specialized medicine and the arising of new (sub-) specialties, diversification in the management of the trauma patient appears to occur...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29300886/how-family-doctors-perceived-their-readiness-and-preparedness-to-identify-and-respond-to-intimate-partner-abuse-a-qualitative-study
#20
Traci Po-Yan Leung, Lisa Phillips, Christina Bryant, Kelsey Hegarty
Background: There are few existing studies which have investigated the meanings of 'readiness' and 'preparedness' among family doctors working with female patients who experience intimate partner abuse (IPA). Objectives: We aimed to explore how doctors perceived the concepts of readiness and preparedness to identify and respond to IPA against female patients. Methods: We adopted purposive sampling and conducted individual semi-structured interviews with 19 doctors (11 females and 8 males) practising in primary care...
December 28, 2017: Family Practice
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