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Primary heath care

Marianne R Scheitel, Maya E Kessler, Jane L Shellum, Steve G Peters, Dawn S Milliner, Hongfang Liu, Ravikumar Komandur Elayavilli, Karl A Poterack, Timothy A Miksch, Jennifer Boysen, Ron A Hankey, Rajeev Chaudhry
BACKGROUND: The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record...
February 8, 2017: Applied Clinical Informatics
Arunjot Singh, William Middlesworth, Julie Khlevner
PURPOSE OF REVIEW: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a congenital aerodigestive anomaly with high survival rates after surgical repair. Care should now be focused on prevention of long-term complications using appropriate surveillance techniques. RECENT FINDINGS: The incidence of gastroesophageal reflux disease (GERD) is high in patients with EA/TEF. Consequences of untreated GERD include esophagitis, strictures, and Barrett esophagus. Subjective symptoms are an unreliable indicator of presence or severity of GERD, and therefore, diagnostic testing is needed to assess esophageal heath and monitor the effectiveness of anti-reflux treatment...
January 2017: Current Gastroenterology Reports
Katharine E H Thomas, Steve Kisely, Fernando Urrego
INTRODUCTION: The American Academy of Pediatrics recommends that pediatricians promote smoking cessation among caregivers at every visit. Currently, there are inconsistencies between recommendations and clinical practice. This study aims to compare results generated from 3 intervention methods on the rate at which pediatricians screen for secondhand smoke exposure (SHSe). METHODS: Pediatricians were randomly assigned to 1 of 3 intervention groups: no lecture, changes in electronic health record (EHR) (G1); lecture, no changes in the EHR (G2); or a lecture and EHR changes (G3)...
January 1, 2017: Clinical Pediatrics
Janna Manjelievskaia, Derek Brown, Katherine A McGlynn, William Anderson, Craig D Shriver, Kangmin Zhu
Importance: Treatment options for patients with young-onset colon cancer remain to be defined and their effects on prognosis are unclear. Objective: To investigate receipt of adjuvant chemotherapy by age category (18-49, 50-64, and 65-75 years) and assess whether age differences in chemotherapy matched survival gains among patients diagnosed as having colon cancer in an equal-access health care system. Design, Setting, and Participants: This cohort study was based on linked and consolidated data from the US Department of Defense's Central Cancer Registry and Military Heath System medical claims databases...
January 25, 2017: JAMA Surgery
Christopher J Weatherburn, Craig A Heath, Stewart W Mercer, Bruce Guthrie
PURPOSE: To measure the prevalence of physical and mental health comorbidities in people with epilepsy in a large population cohort, and to examine the prevalence of depression accounting for other physical comorbidity. METHODS: Population-based, cross-sectional descriptive epidemiology analysis of primary care electronic records for 1,510,742 people aged 14+ years, examining the prevalence of 39 comorbidities. RESULTS: 12,720 people with epilepsy were identified (prevalence 8...
February 2017: Seizure: the Journal of the British Epilepsy Association
Lauren Dayton, Jen Agosti, Deirdre Bernard-Pearl, Marian Earls, Kate Farinholt, Betsy McAlister Groves, Mark Rains, Barry Sarvet, Holly C Wilcox, Lawrence S Wissow
This article provides a synthesis of the lessons learned from the Pediatric Integrated Care Collaborative (PICC), a SAMHSA-funded project that is part of the National Child Traumatic Stress Network. The high prevalence of trauma exposure in childhood and shortage of mental health services has informed efforts to integrate mental and behavioral health services in pediatric primary care. This article outlines strategies to integrate care following the six goals of the PICC change framework: create a trauma/mental health informed office; involve families in program development; collaborate and coordinate with mental health services; promote resilience and prevent mental health problems through a particular focus on trauma-related risks; assess trauma-related somatic and mental health issues; and address trauma-related somatic and mental heath issues...
December 2016: Current Problems in Pediatric and Adolescent Health Care
Sopna M Choudhury, Teresa Arora, Seham Alebbi, Lina Ahmed, Abdi Aden, Omar Omar, Shahrad Taheri
BACKGROUND: Qatar is experiencing rapid population expansion with increasing demands on healthcare services for both acute and chronic conditions. Sourcing accurate information about health conditions is crucial, yet the methods used for sourcing health information in Qatar are currently unknown. Gaining a better understanding of the sources the Qatari population use to recognize and manage health and/or disease will help to develop strategies to educate individuals about existing and emerging health problems...
2016: PloS One
Christopher Dowrick, Iona Heath, Stefan Hjörleifsson, David Misselbrook, Carl May, Joanne Reeve, Deborah Swinglehurst, Peter Toon
No abstract text is available yet for this article.
November 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Karen Zwi, Nikola Morton, Lisa Woodland, Kylie-Ann Mallitt, Pamela Palasanthiran
AIM: This study aimed to determine the prevalence of health conditions in newly arrived refugee children and access to timely heath screening. METHODS: Cross-sectional data from screening of refugee children in regional Australia (2007-12) were analysed for health conditions and timeliness of primary care access. RESULTS: The health of 376 newly arrived refugee children (0-15 years) was assessed. Refugee children came from African (45%), Southeast Asian (29%) and Eastern Mediterranean (10%) regions...
September 4, 2016: Journal of Tropical Pediatrics
Benjamin Coghlan, Heath A Kelly, Sandra J Carlson, Kristina A Grant, Karin Leder, Craig B Dalton, Allen C Cheng
No abstract text is available yet for this article.
June 30, 2016: Communicable Diseases Intelligence Quarterly Report
Anita Villani, Ari Shore, Jonathan D Wasserman, Derek Stephens, Raymond H Kim, Harriet Druker, Bailey Gallinger, Anne Naumer, Wendy Kohlmann, Ana Novokmet, Uri Tabori, Marta Tijerin, Mary-Louise C Greer, Jonathan L Finlay, Joshua D Schiffman, David Malkin
BACKGROUND: Carriers of a germline TP53 pathogenic variant have a substantial lifetime risk of developing cancer. In 2011, we did a prospective observational study of members of families who chose to either undergo a comprehensive surveillance protocol for individuals with Li-Fraumeni syndrome or not. We sought to update our assessment of and modify the surveillance protocol, so in this study we report both longer follow-up of these patients and additional patients who underwent surveillance, as well as update the originally presented surveillance protocol...
September 2016: Lancet Oncology
Ahmed Ali, Yonette Paul, Stanley Madu Nwabudike, Onyekachi Ogbonna, Mica Grantham, Lekidelu Taddesse-Heath
Plasma cell leukemia (PCL) is an uncommon neoplasm of plasma cells, with an aggressive clinical course and poor outcome, even with current standard of care. It can occur either de novo (primary PCL) or as a progression of multiple myeloma (MM). This disease has unique diagnostic criteria but certain genetic markers and clinical features may overlap with MM. Due to the low prevalence of PCL, guidelines on its management are extrapolated from the management of MM and based on small retrospective studies and cases reports/series...
May 2016: Case Reports in Oncology
Helen Elsey, Sudeepa Khanal, Shraddha Manandhar, Dilip Sah, Sushil Chandra Baral, Kamran Siddiqi, James Nicholas Newell
BACKGROUND: By 2030, 80 % of the annual 8.3 million deaths attributable to tobacco will be in low-income countries (LICs). Yet, services to support people to quit tobacco are not part of routine primary care in LICs. This study explored the challenges to implementing a behavioural support (BS) intervention to promote tobacco cessation within primary care in Nepal. METHODS: The study used qualitative and quantitative methods within an action research approach in three primary health care centres (PHCCs) in two districts of Nepal...
July 22, 2016: Implementation Science: IS
Albert Farre, Danai Bem, Gemma Heath, Karen Shaw, Carole Cummins
INTRODUCTION: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field...
2016: BMJ Open
Rachel L Shaw, Helen Lowe, Carol Holland, Helen Pattison, Richard Cooke
OBJECTIVES: To evaluate the implementation of the National Health Service (NHS) Health Check programme in one area of England from the perspective of general practitioners (GPs). DESIGN: A qualitative exploratory study was conducted with GPs and other healthcare professionals involved in delivering the NHS Health Check and with patients. This paper reports the experience of GPs and focuses on the management of the Heath Check programme in primary care. SETTING: Primary care surgeries in the Heart of Birmingham region (now under the auspices of the Birmingham Cross City Clinical Commissioning Group) were invited to take part in the larger scale evaluation...
2016: BMJ Open
P J Schluter, D A Askew, G K Spurling, M Lee, N Hayman
BACKGROUND: Robust oral health epidemiological information for Aboriginal and Torres Strait Islander adults is scant. Set within a large urban population, this study describes self-reported oral health behaviours, status and impact assessed through computerized health checks (HC), stratified by age groups and sex, and identifies associations with dental appearance satisfaction. METHODS: This was a cross-sectional study of Aboriginal and Torres Strait Islander adults (aged ≥20 years) attending the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care between 1 January 2014 and 31 December 2015 who had HC and provided research consent...
March 2017: Australian Dental Journal
Khátia Munguambe, Helena Boene, Marianne Vidler, Cassimo Bique, Diane Sawchuck, Tabassum Firoz, Prestige Tatenda Makanga, Rahat Qureshi, Eusébio Macete, Clara Menéndez, Peter von Dadelszen, Esperança Sevene
BACKGROUND: In countries, such as Mozambique, where maternal mortality remains high, the greatest contribution of mortality comes from the poor and vulnerable communities, who frequently reside in remote and rural areas with limited access to health care services. This study aimed to understand women's health care seeking practices during pregnancy, taking into account the underlying social, cultural and structural barriers to accessing timely appropriate care in Maputo and Gaza Provinces, southern Mozambique...
June 8, 2016: Reproductive Health
Alison Kent, Shamez N Ladhani, Nick J Andrews, Mary Matheson, Anna England, Elizabeth Miller, Paul T Heath
BACKGROUND AND OBJECTIVES: Maternal antenatal pertussis-containing vaccination is recommended for the prevention of neonatal pertussis, but the ability of maternal vaccination to protect premature infants is unknown. We hypothesized that that infants born prematurely to antenatally vaccinated women would have higher pertussis antibody concentrations than those born to unvaccinated women. METHODS: Mothers had been offered a combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine from 28 weeks' gestation as part of their routine antenatal care...
July 2016: Pediatrics
Stephanie L Mayne, Michelle E Ross, Lihai Song, Banita McCarn, Jennifer Steffes, Weiwei Liu, Benyamin Margolis, Romuladus Azuine, Edward Gotlieb, Robert W Grundmeier, Laurel K Leslie, Russell Localio, Richard Wasserman, Alexander G Fiks
BACKGROUND: Primary care pediatricians increasingly care for children's mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. METHODS: This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models...
May 2016: Pediatrics
Nigel Field, Philip Prah, Catherine H Mercer, Greta Rait, Michael King, Jackie A Cassell, Clare Tanton, Laura Heath, Kirstin R Mitchell, Soazig Clifton, Jessica Datta, Kaye Wellings, Anne M Johnson, Pam Sonnenberg
OBJECTIVE: To examine associations between sexual behaviour, sexual function and sexual health service use of individuals with depression in the British general population, to inform primary care and specialist services. SETTING: British general population. PARTICIPANTS: 15,162 men and women aged 16-74 years were interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), undertaken in 2010-2012. Using age-adjusted ORs (aAOR), relative to a comparator group reporting no treatment or symptoms, we compared the sexual health of those reporting treatment for depression in the past year...
March 23, 2016: BMJ Open
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