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https://www.readbyqxmd.com/read/29150885/recognizing-the-haystack-is-the-task-of-the-primary-care-physician
#1
N A Kukutsch, G Argenziano, W Bergman
In a reply to our letter Ferrandiz and colleagues wondered why dermoscopy experts did not already fully embrace teledermoscopy (TD) for suspicious pigmented skin lesions.(1) Our study showed that the structure of the health systems that were investigated differed, with countries where primary care physicians (PCP) hold a gate keeper function and others with direct access to a dermatologist. Significant differences in waiting time and travel distance were observed.(2) Since we believe that there is enough evidence that the addition of high quality dermoscopic pictures to a teleconsultation leads to higher accuracy of the diagnosis we did not investigate this question in our survey...
November 17, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29150472/are-food-and-drink-retailers-within-nhs-venues-adhering-to-nice-quality-standard-94-guidance-on-childhood-obesity-a-cross-sectional-study-of-two-large-secondary-care-nhs-hospitals-in-england
#2
Alice James, Laura Birch, Peter Fletcher, Sally Pearson, Catherine Boyce, Andy R Ness, Julian P Hamilton-Shield, Fiona E Lithander
OBJECTIVE: To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1-3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94. DESIGN: Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals. MAIN OUTCOME MEASURES: Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM)...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#3
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29150313/safety-practices-perceptions-and-behaviors-in-radiation-oncology-a-national-survey-of-radiation-therapists
#4
Kristina Demas Woodhouse, David Hashemi, Kathryn Betcher, Abigail Doucette, Allison Weaver, Brian Monzon, Seth A Rosenthal, Neha Vapiwala
PURPOSE: Radiation therapy is complex and demands high vigilance and precise coordination. Radiation therapists (RTTs) directly deliver radiation and are often the first to discover an error. Yet, few studies have examined the practices of RTTs regarding patient safety. We conducted a national survey to explore the perspectives of RTTs related to quality and safety. METHODS AND MATERIALS: In 2016, an electronic survey was sent to a random sample of 1500 RTTs in the United States...
June 15, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29149936/epidemiology-and-outcomes
#5
REVIEW
Bourke Tillmann, Hannah Wunsch
Sepsis is a global public health concern. Internationally it contributes to more than 5 million deaths annually. Although rates are variable between countries, over the past 40 years reported incidence has continued to increase. Aside from potential differences in patient populations, the variation in reported rates also reflects differences in identification strategies, access to health care, and awareness of the diagnosis. Factors such as age, sex, socioeconomic status, comorbid disease, and type and site of infection impact the development of and outcomes from sepsis...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149914/testing-the-effectiveness-of-a-motivational-interviewing-based-brief-intervention-for-substance-use-as-an-adjunct-to-usual-care-in-community-based-aids-service-organizations-study-protocol-for-a-multisite-randomized-controlled-trial
#6
Bryan R Garner, Heather J Gotham, Stephen J Tueller, Elizabeth L Ball, David Kaiser, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R Rieckmann, Michael Chaple, Erika G Martin, Steve Martino
BACKGROUND: In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1) reducing the number of people who become infected with HIV, (2) increasing access to care and improving health outcomes for people living with HIV, and (3) reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA) funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV) Project...
November 17, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29149903/improving-access-to-school-health-services-as-perceived-by-school-professionals
#7
Janine Bezem, Debbie Heinen, Ria Reis, Simone E Buitendijk, Mattijs E Numans, Paul L Kocken
BACKGROUND: The organisation of health assessments by preventive health services focusing on children's health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals' perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#8
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149875/prevalence-of-antibiotic-prescription-in-pediatric-outpatients-in-italy-the-role-of-local-health-districts-and-primary-care-physicians-in-determining-variation-a-multilevel-design-for-healthcare-decision-support
#9
Mirko Di Martino, Adele Lallo, Ursula Kirchmayer, Marina Davoli, Danilo Fusco
BACKGROUND: According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics...
November 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29149859/medicinal-plants-used-by-women-in-mecca-urban-muslim-and-gendered-knowledge
#10
Afnan Alqethami, Julie A Hawkins, Irene Teixidor-Toneu
BACKGROUND: This study explores medicinal plant knowledge and use among Muslim women in the city of Mecca, Saudi Arabia. Ethnobotanical research in the region has focused on rural populations and male herbal healers in cities, and based on these few studies, it is suggested that medicinal plant knowledge may be eroding. Here, we document lay, female knowledge of medicinal plants in an urban centre, interpreting findings in the light of the growing field of urban ethnobotany and gendered knowledge and in an Islamic context...
November 17, 2017: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/29149852/access-to-health-care-for-persons-with-disabilities-in-rural-south-africa
#11
R Vergunst, L Swartz, K-G Hem, A H Eide, H Mannan, M MacLachlan, G Mji, S H Braathen, M Schneider
BACKGROUND: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29149507/registered-nurse-and-midwife-experiences-of-using-videoconferencing-in-practice-a-systematic-review-of-qualitative-studies
#12
REVIEW
Robyn A Penny, Natalie K Bradford, Danette Langbecker
AIM: To synthesise evidence of registered nurses' and midwives' experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice. BACKGROUND: Videoconferencing is a form of telehealth that can facilitate access to high quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149335/liberty-in-health-care-a-comparative-study-between-hong-kong-and-mainland-china
#13
Jingxian Wu, Ying Mao
This essay contends that individual liberty, understood as the permissibility of making choices about one's own health care in support of one's own good and the good of one's family utilizing private resources, is central to the moral foundations of a health care system. Such individual freedoms are important not only because they often support more efficient and effective health care services, but because they permit individuals to fulfill important moral duties. A comparative study of the health care systems in Hong Kong and mainland China is utilized to illustrate the conceptual and moral concerns at stake...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149096/-fertility-preservation-in-the-oncology-patient
#14
REVIEW
Anibal Scarella Chamy, César Díaz-García, Sonia Herraiz, Jhenifer Kliemchen Rodrigues
In recent years, medical advances have substantially improved survival of cancer patients, generating growing concern about the quality of life of the survivors. Increased attention has been paid to reproductive problems after oncological treatments. International guidelines on fertility preservation in cancer patients require that healthcare teams discuss, as early as possible, the impact of cancer treatments on fertility and encourage access to fertility preservation techniques. The development of these techniques in women is a recent effort and many patients and health care providers are not familiar with their rapid expansion...
November 16, 2017: Medwave
https://www.readbyqxmd.com/read/29148954/our-life-depends-on-this-drug-competence-inequity-and-voluntary-consent-in-clinical-trials-on-supervised-injectable-opioid-assisted-treatment
#15
Daniel Steel, Kirsten Marchand, Eugenia Oviedo-Joekes
Supervised injectable opioid assisted treament (siOAT) prescribes injectable opioids to individuals for whom other forms of addiction treatment have been ineffective. In this article, we examine arguments that opioid-dependent people should be assumed incompetent to voluntarily consent to clinical research on siOAT unless proven otherwise. We agree that concerns about competence and voluntary consent deserve careful attention in this context. But we oppose framing the issue solely as a matter of the competence of opioid-dependent people and emphasize that it should be considered in the context of inequities in access to siOAT as a medical treatment...
December 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29148566/factors-that-influence-the-provision-of-intrapartum-and-postnatal-care-by-skilled-birth-attendants-in-low-and-middle-income-countries-a-qualitative-evidence-synthesis
#16
REVIEW
Susan Munabi-Babigumira, Claire Glenton, Simon Lewin, Atle Fretheim, Harriet Nabudere
BACKGROUND: In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148341/the-affordable-care-act-appears-to-have-narrowed-racial-and-ethnic-disparities-in-insurance-coverage-and-access-to-care-among-young-adults
#17
Brandy J Lipton, Sandra L Decker, Benjamin D Sommers
Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act's 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites...
April 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148338/comprehensive-support-for-family-caregivers-impact-on-veteran-health-care-utilization-and-costs
#18
Courtney Harold Van Houtven, Valerie A Smith, Karen M Stechuchak, Megan Shepherd-Banigan, Susan Nicole Hastings, Matthew L Maciejewski, Gilbert Darryl Wieland, Maren K Olsen, Katherine E M Miller, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Eugene Z Oddone
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148335/geographic-variation-in-medicaid-acceptance-across-michigan-primary-care-practices-in-the-era-of-the-affordable-care-act
#19
Renuka Tipirneni, Karin V Rhodes, Rodney A Hayward, Richard L Lichtenstein, HwaJung Choi, Emily K Arntson, Jessica M Landgraf, Matthew M Davis
Coverage and access have improved under the Affordable Care Act, yet it is unclear whether recent gains have reached those regions within states that were most in need of improved access to care. We examined geographic variation in Medicaid acceptance among Michigan primary care practices before and after Medicaid expansion in the state, using data from a simulated patient study of primary care practices. We used logistic regression analysis with time indicators to assess regional changes in Medicaid acceptance over time...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148324/the-impacts-of-medicaid-expansion-on-rural-low-income-adults-lessons-from-the-oregon-health-insurance-experiment
#20
Heidi Allen, Bill Wright, Lauren Broffman
Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for context...
January 1, 2017: Medical Care Research and Review: MCRR
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