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Specialist referrals

Tariq Alhogbani, Fuad A Awwad, Abdullah S Aljasser
Objectives: To evaluate knowledge and attitude of physicians involved in the management of patients with heart failure regarding implantable cardioverter-defibrillator (ICD). Methods: We conducted personal interviews with physicians involved in treating patients with heart failure. Between October 2015 and February 2016, the study was conducted in hospitals in the Riyadh region where no cardiac electrophysiology service was available. Every participant was met in person and received an oral questionnaire that aimed to assess basic knowledge regarding ICD indications and benefits...
April 2018: Journal of the Saudi Heart Association
Abdulla Ibrahim, Mahmoud K Nassar, Daniel J Jordan, Manish Sinha, Fiona J Hogg
The Adult Exceptional Aesthetic Referral Protocol (AEARP) encompasses a series of aesthetic procedures which, as they do not treat an underlying disease process, are not routinely available within the National Health Service. Provision of these services can only be provided on an exceptional basis. In this prospective study, we evaluated the referral process and outcomes of 1122 patients referred under the AEARP over a 3.5-year period. Referrals were screened by a vetting panel comprising of a plastic surgeon, clinical nurse specialist, and clinical psychologist...
May 22, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Lauren Ross, Adam de Gruchy, Uyen M Phan, Matthew Warrender-Sparkes, Ian P Wicks, John Hy Moi
No abstract text is available yet for this article.
June 18, 2018: Medical Journal of Australia
H M M T B Herath, B S D P Keragala, W A E Udeshika, S S M Samarawickrama, S P Pahalagamage, Aruna Kulatunga, Chaturaka Rodrigo
OBJECTIVES: This study aimed to assess the knowledge, attitudes and skills of non-specialist doctors on timely referral of suspicious lesions for melanoma diagnosis. RESULTS: One hundred and twenty-three doctors (mean age; 30.4 years, SD ± 8.015) were enrolled. Very few (3.3%) correctly stated all four types of melanoma. Only 8.1% of the total sample had been trained to perform a total body examination for skin cancer detection and a majority (110/123) had never performed one...
June 14, 2018: BMC Research Notes
Alexandru M Rotar, Michael J Van Den Berg, Willemijn Schäfer, Dionne S Kringos, Niek S Klazinga
Primary care faces challenging times in many countries, mainly caused by an ageing population. The GPs' role to match patients' demand with medical need becomes increasingly complex with the growing multiple conditions population. Shared decision-making (SDM) is recognized as ideal to the treatment decision making process. Understanding GPs' perception on SDM about patient referrals and whether patients' preferences are considered, becomes increasingly important for improving health outcomes and patient satisfaction...
2018: PloS One
Joshua J Thomas, Anthony A Stans, Todd A Milbrandt, Vickie M Treder, Hilal Maradit Kremers, William J Shaughnessy, A Noelle Larson
BACKGROUND: With new data supporting the efficacy of bracing, the role of school screening for early detection of moderate scoliosis curves has been revisited. Because of a high rate of false-positive screening and cost concerns, a comprehensive county-wide school screening program was discontinued in 2004. We aim to determine the impact of a comprehensive school screening program on curve magnitude at presentation and initial scoliosis treatment for all local county patients presenting to a pediatric orthopedic clinic from all referral sources...
July 2018: Spine Deformity
Carolina Barbosa, Brendan Wedehase, Laura Dunlap, Shannon Gwin Mitchell, Kristi Dusek, Robert P Schwartz, Jan Gryzcynski, Arethusa S Kirk, Marla Oros, Colleen Hosler, Kevin E O'Grady, Barry S Brown
OBJECTIVE: Understanding the costs to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescent substance use in primary care settings is important for providers in planning for services and for decision makers considering dissemination and widespread implementation of SBIRT. We estimated the start-up costs of two models of SBIRT for adolescents in a multisite U.S. Federally Qualified Health Center (FQHC). In both models, screening was performed by a medical assistant, but models differed on delivery of brief intervention, with brief intervention delivered by a primary care provider in the generalist model and a behavioral health specialist in the specialist model...
May 2018: Journal of Studies on Alcohol and Drugs
B Flynn, M Barrett, J Sui, C Halpin, G Paz, D Walsh
BACKGROUND: Cancer cachexia is a multifactorial syndrome characterised by a progressive loss of skeletal muscle mass. It adversely influences quality of life, treatment response and survival. Early identification and multimodal interventions can potentially treat cancer cachexia. However, healthcare professionals demonstrate a lack of understanding and the ability to identify cancer cachexia early. The present study aimed to evaluate the assessment by physicians of nutritional status in cancer patients admitted to hospice...
June 7, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Gill Hubbard, Anna Campbell, Abi Fisher, Michelle Harvie, Wendy Maltinsky, Russell Mullen, Elspeth Banks, Jackie Gracey, Trish Gorely, Julie Munro, Gozde Ozakinci
Background: Physical activity (PA) programmes effective under 'research' conditions may not be effective under 'real-world' conditions. A potential solution is to refer patients to existing PA community-based PA services. Methods: A process evaluation of referral of post-surgical patients with early-stage breast cancer to cardiac rehabilitation exercise classes, leisure centre with 3-month free leisure centre membership or telephone-delivered PA consultations for 12 weeks...
2018: Pilot and Feasibility Studies
Endang R Surjaningrum, Harry Minas, Anthony F Jorm, Ritsuko Kakuma
Background: Indonesian maternal health policies state that community health workers (CHWs) are responsible for detection and referral of pregnant women and postpartum mothers who might suffer from mental health problems (task-sharing). The documents have been published for a while, however reports on the implementation are hardly found which possibly resulted from feasibility issue within the health system. Aims: To examine the feasibility of task-sharing in integrated mental health care to identify perinatal depression in Surabaya, Indonesia...
2018: International Journal of Mental Health Systems
Jessica L Common, Hensley H Mariathas, Kaylah Parsons, Jonathan D Greenland, Scott Harris, Rick Bhatia, SuzanneC Byrne
BACKGROUND: A multidisciplinary, centralized referral program was established at our institution in 2014 to reduce delays in lung cancer diagnosis and treatment following diagnostic imaging observed with the traditional, primary care provider-led referral process. The main objectives of this retrospective cohort study were to determine if referral to a Thoracic Triage Panel (TTP): 1) expedites lung cancer diagnosis and treatment initiation; and 2) leads to more appropriate specialist consultation...
June 4, 2018: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Shamil Haroon, Darren Wooldridge, Jan Hoogewerf, Krishnarajah Nirantharakumar, John Williams, Lina Martino, Neeraj Bhala
BACKGROUND: Alcohol misuse is an important cause of premature disability and death. While clinicians are recommended to ask patients about alcohol use and provide brief interventions and specialist referral, this is poorly implemented in routine practice. We undertook a national consultation to ascertain the appropriateness of proposed standards for recording information about alcohol use in electronic health records (EHRs) in the UK and to identify potential barriers and facilitators to their implementation in practice...
June 7, 2018: BMC Medical Informatics and Decision Making
Felicity Mayer, Debra Bick, Cath Taylor
BACKGROUND: Cardiac disease is associated with adverse outcomes in pregnancy and is the leading cause of indirect maternal death in the United Kingdom (UK) and internationally. National and international guidelines recommend women should receive care from multidisciplinary teams; however evidence is lacking to inform how they should be operationalised. OBJECTIVES: To describe the composition and processes of multidisciplinary care between maternity and cardiac services before, during and after pregnancy for women with cardiac disease, and explore clinicians' (cardiologists, obstetricians, nurses, midwives) and women's experiences of delivering/receiving care within these models...
May 22, 2018: International Journal of Nursing Studies
Mia T Minen, Sarah Azarchi, Rachel Sobolev, Amanda Shallcross, Audrey Halpern, Thomas Berk, Naomi M Simon, Scott Powers, Richard B Lipton, Elizabeth Seng
Objective: To evaluate the frequency with which migraine patients initiated behavioral migraine treatment following a headache specialist recommendation and the predictors for initiating behavioral migraine treatment. Methods: We conducted a prospective cohort study of consecutive patients diagnosed with migraine to examine whether the patients initiated behavioral migraine treatment following a provider recommendation. The primary outcome was scheduling the initial visit for behavioral migraine treatment...
June 5, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Karen Kenyon, Clair Hebron, Pirjo Vuoskoski, Carol McCrum
BACKGROUND: Physiotherapy is recommended for upper limb movement impairments (ULMI) following breast cancer treatment. There is limited research into the pathophysiology and management of ULMI. Care is provided in different health-care contexts by specialist and nonspecialist physiotherapists, with referrals set to increase. This study explores physiotherapists' experiences of managing ULMI. DESIGN: Qualitative study using a hermeneutic phenomenological approach...
June 7, 2018: Physiotherapy Theory and Practice
Emma Pullen, Dominic Malcolm, Patrick Wheeler
BACKGROUND: Regular participation in sport, exercise and physical activity is associated with positive health outcomes and form a mainstay of British public health policies. However, regular participation in sport and exercise can result in sport related injury (SRI) which, in turn, is a key cause of exercise cessation. The integration of Sport and Exercise Medicine (SEM) in the English National Health Service (NHS) aims to provide a specialist service for public populations and thus reduce the impact of SRI on exercise cessation and associated negative health outcomes...
June 7, 2018: Journal of Sports Medicine and Physical Fitness
Alessandro Salustri, Salah El Badri, Abdul Haleem Shawky, Hakam Alzaeem
The incidence of degenerative heart valve disease is rising in developing countries and diagnosis, assessment and management are becoming increasingly complex. The availability of new interventional procedures has further expanded the therapeutic armamentarium, but at the same time, it has increased the proportion of high-risk patients, in whom risk-benefit analysis and the choice of the most appropriate therapy are particularly difficult. Accordingly, international societies have recommended dedicated heart valve clinics (HVCs) to meet these needs...
January 2018: Heart Views: the Official Journal of the Gulf Heart Association
Matthew J Allsop, Lucy E Ziegler, Matthew R Mulvey, Sarah Russell, Ros Taylor, Michael I Bennett
BACKGROUND: Understanding service provision for patients with advanced disease is a research priority, with a need to identify barriers that limit widespread integration of palliative care. AIM: To identify patient and organisational factors that influence the duration of hospice-based palliative care in the United Kingdom prior to death. DESIGN: This is a retrospective cohort study. SETTING/PARTICIPANTS: A total of 64 UK hospices providing specialist palliative care inpatient beds and community services extracted data for all adult decedents (aged over 17 years) with progressive, advanced disease, with a prior referral (e...
June 1, 2018: Palliative Medicine
Simon Rice, Andrea Polari, Andrew Thompson, Jessica Hartmann, Patrick McGorry, Barnaby Nelson
AIM: To examine reasons for referral to a specialist ultra-high risk (UHR) for psychosis clinic and whether these reasons are associated with risk for subsequent transition to psychosis. METHODS: Data for 127 patients referred to the Personal Assessment and Crisis Evaluation clinic were collected by medical record audit. Time to transition to psychosis was calculated from date of referral to time at which the young person was judged by their treating team to be experiencing onset of first episode psychosis...
June 6, 2018: Early Intervention in Psychiatry
Cristina Ardura-Garcia, Marie Stolbrink, Seher Zaidi, Philip J Cooper, John D Blakey
BACKGROUND: Asthma attacks are common and have significant physical, psychological, and financial consequences. Improving the assessment of a child's risk of subsequent asthma attacks could support front-line clinicians' decisions on augmenting chronic treatment or specialist referral. We aimed to identify predictors for emergency department (ED) or hospital readmission for asthma from the published literature. METHODS: We searched MEDLINE, EMBASE, AMED, PsycINFO, and CINAHL with no language, location, or time restrictions...
June 5, 2018: Pediatric Pulmonology
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