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https://www.readbyqxmd.com/read/28813734/the-36-hour-day-revisited-implementing-a-caregiver-support-system-into-primary-care-practice
#1
Rachel Sunne, Mark K Huntington
An estimated 5.3 million Americans had Alzheimer's disease in 2015. With the aging population and rapid rise in those with dementia, it is vital to not only care for the dementia patient, but also his or her primary caregiver. Caregivers often suffer from depression and neglect their own health in order to care for their loved one. In this regard, included is a review of the role of the primary care physician including the importance of discussing the diagnosis of dementia with the patient and family, providing supportive services and resources, as well as the challenges that many physicians face in tackling the care of a dementia caregiver...
April 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813717/exploring-the-use-of-a-participative-design-in-the-early-development-of-a-predictive-test-the-importance-of-physician-involvement
#2
Sophie Veilleux, Maude Villeneuve, Nathalie Lachapelle, Rita Kohen, Luc Vachon, Brian White Guay, John D Rioux, Alain Bitton
In this study, we contribute to the personalized medicine and health care management literature by developing and testing a new participative design approach. We propose that involving gastroenterologists in the development of a predictive test to assist them in their clinical decision-making process for the treatment of inflammatory bowel diseases will increase the likelihood of their acceptance of the innovation. Based on data obtained from 6 focus groups across Canada from a total of 28 physicians, analyses reveal that current tools do not enable discriminating between treatment options to find the best fit for each patient...
August 17, 2017: Public Health Genomics
https://www.readbyqxmd.com/read/28813524/medical-student-nursing-student-and-non-health-care-respondents-implicit-attitudes-toward-doctors-and-patients-development-and-a-pilot-study-of-a-new-implicit-attitudes-test-iat
#3
Alan Schwartz, Abdelhamid Mazouni
INTRODUCTION: Medical educators have been concerned that medical students may decline in empathy for patients during the course of their training, based on studies measuring clinical empathy using psychometrically strong self-report measures. Clinical empathy is a complex construct, incorporating attitudes toward patients but also other components, such as professional detachment. Triangulation of extant measures with instruments based on nonreactive methods could provide a better understanding of whether and how physician attitudes toward patients may be changing during training...
2017: PloS One
https://www.readbyqxmd.com/read/28813502/addressing-the-challenge-of-high-priced-prescription-drugs-in-the-era-of-precision-medicine-a-systematic-review-of-drug-life-cycles-therapeutic-drug-markets-and-regulatory-frameworks
#4
Toon van der Gronde, Carin A Uyl-de Groot, Toine Pieters
CONTEXT: Recent public outcry has highlighted the rising cost of prescription drugs worldwide, which in several disease areas outpaces other health care expenditures and results in a suboptimal global availability of essential medicines. METHOD: A systematic review of Pubmed, the Financial Times, the New York Times, the Wall Street Journal and the Guardian was performed to identify articles related to the pricing of medicines. FINDINGS: Changes in drug life cycles have dramatically affected patent medicine markets, which have long been considered a self-evident and self-sustainable source of income for highly profitable drug companies...
2017: PloS One
https://www.readbyqxmd.com/read/28812844/clinician-perspectives-of-barriers-to-effective-implementation-of-a-rapid-response-system-in-an-academic-health-centre-a-focus-group-study
#5
John Rihari-Thomas, Michelle DiGiacomo, Jane Phillips, Phillip Newton, Patricia M Davidson
BACKGROUND: Systemic and structural issues of rapid response system (RRS) models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses) experience and negotiate care for deteriorating patients within the RRS. METHODS: Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis...
January 1, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812834/cost-effectiveness-of-rural-incentive-packages-for-graduating-medical-students-in-lao-pdr
#6
Eric Keuffell, Wanda Jaskiewicz, Khampasong Theppanya, Kate Tulenko
BACKGROUND: The dearth of health workers in rural settings in Lao People's Democratic Republic (PDR) and other developing countries limits healthcare access and outcomes. In evaluating non-wage financial incentive packages as a potential policy option to attract health workers to rural settings, understanding the expected costs and effects of the various programs ex ante can assist policy-makers in selecting the optimal incentive package. METHODS: We use discrete choice experiments (DCEs), costing analyses and recent empirical results linking health worker density and health outcomes to estimate the future location decisions of physicians and determine the cost-effectiveness of 15 voluntary incentives packages for new physicians in Lao PDR...
October 29, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812129/-device-based-remote-monitoring-current-evidence
#7
REVIEW
David Duncker, Roman Michalski, Johanna Müller-Leisse, Christos Zormpas, Thorben König, Christian Veltmann
Telemedicine is increasingly used in clinical cardiology. It offers early detection of arrhythmias, technical device follow-up and support of heart failure management. Regarding technical device follow-up, remote monitoring significantly reduces usage of the health care system. Furthermore, remote monitoring is associated with a significantly reduced time from device malfunction to physician's perception of the event. Using remote monitoring, inappropriate ICD (implantable cardioverter defibrillator) shocks can be significantly reduced compared to routine in-office follow-up...
August 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#8
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811907/factors-associated-with-antibiotic-prescriptions-for-the-viral-origin-diseases-in-office-based-practices-2006-2012
#9
Sara Imanpour, Obioma Nwaiwu, Darcy K McMaughan, Bethany DeSalvo, Adnan Bashir
OBJECTIVE: To test the potential association between time spent with a doctor and antibiotic overprescriptions in case of the common cold, runny nose, bronchitis, chest colds, flu, sore throats, and fluid in the middle ear. DESIGN: Cross-sectional study. SETTING: Office-based physicians in the US. PARTICIPANTS: A total of 261,623 patient visits recorded to office-based physicians in the US. MAIN OUTCOME MEASURES: The interest outcome was unnecessary antibiotic prescription...
August 2017: JRSM Open
https://www.readbyqxmd.com/read/28811089/physician-experiences-with-clinical-pharmacists-in-primary-care-teams
#10
Gerardo Moreno, Sarah Lonowski, Jeffrey Fu, Janet S Chon, Natalie Whitmire, Carolina Vasquez, Samuel A Skootsky, Douglas S Bell, Richard Maranon, Carol M Mangione
BACKGROUND: Improving medication management is an important component of comprehensive care coordination for health systems. The Managing Your Medication for Education and Daily Support (MyMeds) medication management program at the University of California Los Angeles addresses medication management issues by embedding trained clinical pharmacists in primary care practice teams. OBJECTIVES: The aim of this work was to examine and explore physician opinions about the clinical pharmacist program and identify common themes among physician experiences as well as barriers to integration of clinical pharmacists into primary care practice teams...
August 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28810997/cutaneous-leishmaniasis-in-a-saudi-arabian-soldier-stationed-in-the-united-states
#11
Kelly Laurent, Jason Susong, Eric Fillman, Simon Ritchie
BACKGROUND: Leishmaniasis is a common parasitic disease seen in many parts of the world, especially in areas where current U.S. and international forces are deployed. Approximately 350 million people are thought to be at risk of cutaneous leishmaniasis (CL) with an annual incidence of 1.5 million cases. Over 90% of cutaneous infections with Leishmania occur in the Middle East, Brazil, and Peru. Outbreaks of CL may occur in military personnel deployed to endemic areas. Since the incubation period for symptomatic CL ranges from weeks to months, symptoms may not appear until well after returning to the United States...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810976/women-s-health-knowledge-and-skills-among-transitional-year-internship-trained-military-medical-officers-serving-as-independent-health-care-providers
#12
Ryan J Heitmann, Crystal B Hammons, Alison L Batig
BACKGROUND: Women comprise 14.5% of active duty service members. Delivery of women's health services is a critical component to personal, medical, and mission readiness. Our objective was to evaluate the knowledge, skills, and practices pertaining to basic elements of women's/reproductive health issues among transitional internship-trained general medical officers in the Army, Navy, and Air Force. MATERIALS AND METHODS: This is a cross-sectional survey study of transitional internship-trained graduates from 2012 to 2015 who transitioned to an operational assignment as an independent provider after internship graduation...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810911/outcomes-from-patients-with-presumed-drug-resistant-tuberculosis-in-five-reference-centers-in-brazil
#13
D M P Ramalho, P F C Miranda, M K Andrade, T Brígido, M P Dalcolmo, E Mesquita, C F Dias, A N Gambirasio, J Ueleres Braga, A Detjen, P P J Phillips, I Langley, P I Fujiwara, S B Squire, M M Oliveira, A L Kritski
BACKGROUND: The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. METHODS: Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28810894/chikungunya-an-emerging-viral-infection-with-varied-clinical-presentations-in-bangladesh-reports-of-seven-cases
#14
Muhammad Abdur Rahim, Khwaja Nazim Uddin
BACKGROUND: Chikungunya is an emerging and rapidly spreading viral infection in many parts of the world including Bangladesh. It shares many epidemiological and clinical characteristics with dengue. So, a sound knowledge is required for its detection and differentiation from dengue, specially in endemic regions. CASE PRESENTATION: We present seven confirmed cases of chikungunya having different clinical presentations occurring among middle aged males and females from different socio-economic background in Dhaka city, the capital of Bangladesh...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28810817/struggles-over-antibiotics-physicians-stance-taking-toward-a-nonconforming-policy-in-an-intensive-care-unit
#15
Letizia Caronia, Marzia Saglietti
One of the most pressing contemporary health care challenges consists in rethinking antibiotic use to contrast the increase of multidrug resistant bacteria. Drawing on an ethnographic fieldwork in an Intensive Care Unit that adopts a nonconforming policy of antibiotic stewardship, this article analyzes doctor-doctor interaction concerning infectious disease diagnosis and antibiotic treatment. By analyzing examples of medical decision-making from a corpus of video-recorded morning briefings, we focus on physicians' stance-taking toward the ward's nonconforming policy and illustrate how it is contingently situated along a continuum from strong commitment to overt resistance...
August 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28810485/risk-perception-self-efficacy-trust-for-physician-depression-and-behavior-modification-in-diabetic-patients
#16
Hissei Imai, Toshiaki A Furukawa, Shin-U Hayashi, Atsushi Goto, Kazuo Izumi, Yasuaki Hayashino, Mitsuhiko Noda
We evaluated the associations of risk perception, self-efficacy, and trust with two health promotion behaviors (food habits and exercise) and depressive mood. Diabetic patients aged between 40 and 64 ( n = 1195) were included in the analyses. Risk perception worsened behavioral changes in terms of food habits and depression, whereas self-efficacy and trust improved food habits, exercise, and depression; trust improved exercise and depression. In conclusion, self-efficacy and trust appear to be more beneficial than risk perception for positive behavioral changes and for improving depression in diabetic patients...
July 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810112/patient-and-physician-perceptions-of-genetic-testing-in-primary-care
#17
Samuel A Evenson, H Eugene Hoyme, Jan E Haugen-Rogers, Eric A Larson, Susan E Puumala
INTRODUCTION: The convergence of biomedical informatics and translational genomics is changing the way we practice. Primary care will play a pivotal role in this transformation. We therefore sought to assess general knowledge about genetic testing among outpatient internal medicine providers, and the patients that they serve across a five state region in the Midwest. METHODS: One thousand take-home paper surveys were created and distributed to internal medicine patients at 13 Midwestern clinics...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28810082/therapeutic-monoclonal-antibodies-and-clinical-laboratory-tests-when-why-and-what-is-expected
#18
Zhanhu Zhang, Wenjie Hu, Linlin Li, Hongxia Ding, Haibo Li
BACKGROUND: We herein provide an overview of the clinical laboratory tests that should be performed before, during and after using therapeutic monoclonal antibodies (mAbs) and the clinical laboratory tests that may be affected by mAbs. METHODS: The labels of FDA-approved therapeutic mAbs were downloaded from DailyMed (the official website for drug labels) and were used as the sources of data for this review. RESULTS: It was found that most of the labels provided information relevant to the clinical laboratory tests, including the tests needed before mAbs treatment to check the patients' background status and to identify potentially sensitive patients, the tests needed during or after the treatment to evaluate the patients' response, and the mAbs that may lead to false positive or negative results for clinical laboratory tests...
August 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28809602/fertility-preservation-and-sexual-health-after-cancer-therapy
#19
Nigel Pereira, Glenn L Schattman
Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age-fertility preservation and sexual function...
August 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28809590/brand-trust-and-image-effects-on-customer-satisfaction
#20
Sayed Hamid Khodadad Hosseini, Leila Behboudi
Purpose The purpose of this paper is to investigate brand trust and brand image effects on healthcare service users. Nowadays, managers and health activists are showing increased tendency to marketing and branding to attract and satisfy customers. Design/methodology/approach The current study's design is based on a conceptual model examining brand trust and brand image effects on customer satisfaction. Data obtained from 240 questionnaires (310 respondents) were analyzed using path analysis. Findings Results revealed that the most effective items bearing the highest influence on customer satisfaction and on benefiting from healthcare services include brand image, staff sincerity to its patients, interactions with physicians and rapport...
August 14, 2017: International Journal of Health Care Quality Assurance
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