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Annual wellness visit

Emily N B Myer, Jennifer L Roem, David A Lovejoy, Melinda G Abernethy, Joan L Blomquist, Victoria L Handa
BACKGROUND: There is limited knowledge of the effects of time on change in pelvic floor muscle strength after childbirth. OBJECTIVE: The objectives of this study were to estimate the change in pelvic floor muscle strength in parous women over time and to identify maternal and obstetric characteristics associated with the rate of change. STUDY DESIGN: This is an IRB approved prospective cohort study of parous women. Participants were recruited 5-10 years after first delivery and followed annually...
June 11, 2018: American Journal of Obstetrics and Gynecology
Kyoichi Adachi, Tomoko Mishiro, Takashi Toda, Naomi Kano, Harumi Fujihara, Yuko Mishima, Atsuko Konishi, Mariko Mochida, Kazuko Takahashi, Yoshikazu Kinoshita
The purpose was to clarify the effects of Helicobacter pylori ( H. pylori ) eradication on the changes in serum lipid levels by comparing subjects with and without continuous H. pylori infection. The study subjects were 774 individuals (males 536, females 238, mean age 52.6 years) who visited between April 2013 and March 2016 for annual medical checkups. Serum total cholesterol, high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), and triglyceride levels, and LDLC/HDLC ratio were compared between the subjects with and without H...
May 2018: Journal of Clinical Biochemistry and Nutrition
Magdalena Platikanova, Petya Hristova, Hristina Milcheva
AIM: This paper aims to create a mathematical model for forecasting the morbidity of the population in the Republic of Bulgaria and the Stara Zagora Municipality in particular as a consequence of the atmospheric pollution. SUBJECTS AND METHODS: This model is based on a formula which determines the correlation between the average annual concentrations of atmospheric pollutants SO2 , PM10 , Pb aerosols, NO2 and H2 S) and the morbidity of the population based on the number of people who visited their GPs in a relation with a chronic health problem or emergency condition and the number of hospitalisations in two age groups (newborn to 17 years olds and 18 and older) as well as for the entire population in the period 2009-2013, making it possible to predict morbidity levels...
May 20, 2018: Open Access Macedonian Journal of Medical Sciences
Guoyu Tao
Annual wellness visit (AWV) was introduced for Medicare patients in 2011 to help patients stay healthy. The object of this study is to assess whether AWV have an impact on the use of other preventive services in the eligible population. Medicare claims for the full sample of beneficiaries who were continuously enrolled in fee-for-service Medicare in 2013 and 2014 were analyzed. The association between AWV and three other preventive services (depression screening [DPS], influenza virus vaccine [IVV], and sexually transmitted infection screening [STI]) were assessed...
June 2018: Preventive Medicine Reports
Jane Trinh, Nicholas Turner
Background: Hepatitis C (HCV) is a viral liver disease that can result in cirrhosis, hepatocellular carcinoma, liver transplantation or death. The Centers for Disease Control (CDC) estimates that 2.7-3.9 million Americans are living with HCV, yet the majority are unaware. Starting in 2013, both CDC and US Preventative Services Task Force guidelines agreed in recommending HCV screening for all those born between 1945 and 1965 yet many clinics have been slow to adopt screening. Objective: We designed a quality improvement project seeking to improve HCV screening rates among patients seen for new or annual visits to ≥90% over a 3-year period in an academic primary care clinic...
2018: BMJ Open Quality
Amal A Wanigatunga, Ravi Varadhan, Eleanor M Simonsick, Olga D Carlson, Stephanie Studenski, Luigi Ferrucci, Jennifer A Schrack
Background: Chronically elevated interleukin-6 (IL-6) levels contribute to fatigue and functional decline via multiple pathways that often lead to frailty. Lesser known is the contribution of IL-6 to fatigue in relation to a standardized workload (fatigability), a precursor to functional decline. Therefore, the purpose of this study was to examine the longitudinal relationship between IL-6 and fatigability. Methods: 985 participants from the Baltimore Longitudinal Study of Aging (mean age: 70+/-10 years) were evaluated every 1-4 years...
May 26, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Toby Myatt, Brian J Nguyen, Richard F Clark, Christanne H Coffey, Charles W O'Connell
BACKGROUND: Stingray injuries result in thousands of emergency department visits annually. OBJECTIVES: This study aimed to assess the complication rate and outcome of field treatment with hot water immersion. METHODS: This was an on-site, prospective, observational study. Subjects were enrolled after having been stung by a stingray. A trained researcher obtained the following information: age, sex, health conditions and medications, and wound description...
May 23, 2018: Journal of Emergency Medicine
Michael A Rosen, Deborah DiazGranados, Aaron S Dietz, Lauren E Benishek, David Thompson, Peter J Pronovost, Sallie J Weaver
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue...
May 2018: American Psychologist
James R Mahalik, Faedra R Backus Dagirmanjian
To understand influences on medical help seeking in men from traditionally masculine occupations, semistructured interviews with 12 men employed in manual and industrial labor were conducted. The semistructured interview format explored participant men's understanding and experiences of annual exams and medical help seeking, their own and others' reactions to seeking medical help, and influences on their own care and understanding of what it means to seek medical care. Utilizing consensual qualitative research methodology, five domains emerged: Social norms around medical care, managing threat, getting medical help is gendered, work-related influences, and pragmatic contributors to medical help seeking...
May 1, 2018: American Journal of Men's Health
Deydre S Teyhen, Stephen L Goffar, Scott W Shaffer, Kyle Kiesel, Robert J Butler, Ann-Maree Tedaldi, Jennifer C Prye, Daniel I Rhon, Phillip J Plisky
Study Design A prospective observational cohort. Background Musculoskeletal injuries during military service are a primary source of disability resulting in 2.4 million annual health care visits and 25 million limited-duty days. While the injury incidence during basic training is well documented there is little understanding of injury distribution by organization type in the Army following initial training. Objective Compare injury incidence, distribution, and impact across various military units. Methods Comprehensive injury data from subject questionnaires and medical chart reviews were collected for 1430 initially healthy Army personnel representing combat, combat support, combat service support, and ranger units over 12 months...
May 22, 2018: Journal of Orthopaedic and Sports Physical Therapy
Yuanyuan Liu, Xiang Liu, Hong Wen, Dan Wang, Xianmei Yang, Weiwei Tang, Yaxi Li, Tao Zhang, Min Yang
BACKGROUND: The management of severe mental disorder (SMD) patients in communities is an important initiative of healthcare reform in China. Yet the effects in terms of risk behavior of patients are unclear, particularly in rural areas. This study aims to examine high risk behaviors, changing trends, and possible associated factors among SMD patients in the rural areas of western China. METHODS: This analysis examined incidence rate (IR) of high risk behavior of 121,830 managed SMD patients in rural area of Sichuan province, based on data from the national system from 2006 to 2013...
May 18, 2018: BMC Psychiatry
Igor Shumskiy, Troy Richardson, Sumeet Brar, Matt Hall, Joanne Cox, Charis Crofton, Alon Peltz, Margaret Samuels-Kalow, Elizabeth R Alpern, Mark I Neuman, Jay G Berry
OBJECTIVE: Well-child visits (WCVs) help optimize children's health. We measured annual WCVs for children with medical complexity (CMC) and correlated WCVs with hospitalizations. STUDY DESIGN: This was a retrospective analysis of 93 121 CMC aged 1-18 years continuously enrolled in 10 state Medicaid programs in the Truven MarketScan Database between 2010 and 2014. CMC had a complex chronic condition or 3 or more chronic conditions of any complexity identified from International Classification of Diseases, Ninth Revision codes, and the use of 1 or more chronic medications...
May 8, 2018: Journal of Pediatrics
Elizabeth Burns, Ramakrishna Kakara
Deaths from unintentional injuries are the seventh leading cause of death among older adults (1), and falls account for the largest percentage of those deaths. Approximately one in four U.S. residents aged ≥65 years (older adults) report falling each year (2), and fall-related emergency department visits are estimated at approximately 3 million per year.* In 2016, a total of 29,668 U.S. residents aged ≥65 years died as the result of a fall (age-adjusted rate†  = 61.6 per 100,000), compared with 18,334 deaths (47...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
Brittany Albrecht, Shelley Giebel, Michelle McCarron, Bhanu Prasad
We summarize the case of an 81-year-old Caucasian female who presented to her family physician with signs and symptoms of nephrotic syndrome following a brief exposure to quinine. Prior to that visit, she was clinically well with no chronic medical ailments and met with her family physician for annual physical assessments. She had taken 11 tablets of quinine for nocturnal leg cramps over the course of 28 days before starting to notice mild peripheral edema, which subsequently progressed, leading to a family physician review...
March 7, 2018: Curēus
Kathy Kemle, Richard J Ackermann
Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives...
May 2018: FP Essentials
Richard J Ackermann
Medicare covers annual wellness visits that are scheduled separately from regular medical appointments. These visits focus on prevention and health maintenance to help patients achieve successful aging, which is defined as living to old age without disability while also maintaining high physical and psychological levels of functioning and social engagement. To achieve these goals, most adults should perform at least 150 min/week of moderate-intensity exercise and maintain an optimal body mass index (ie, 23 to 32 kg/m2 )...
May 2018: FP Essentials
Rosaline S Zhang, Lawrence O Lin, Ian C Hoppe, Oksana A Jackson, David W Low, Scott P Bartlett, Jordan W Swanson, Jesse A Taylor
OBJECTIVE: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. DESIGN: Retrospective cross-sectional study. SETTING: Cleft Lip and Palate Program, Children's Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4...
January 1, 2018: Cleft Palate-craniofacial Journal
Rachel N Criner, MeiLan K Han
COPD is an underdiagnosed, undertreated, and yet largely preventable disease. COPD affects millions of Americans on a daily basis, accounts for tens of thousands of deaths per year, and costs billions to the United States health-care system annually. Further, it impacts the quality of life for patients living with the disease. COPD care is fragmented in the United States, with a high level of responsibility placed on patients and their primary care physicians. Pulmonary specialists care for a minority of patients with COPD in the United States...
May 2018: Respiratory Care
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
Nicole R Fowler, Noll L Campbell, Gerhardt M Pohl, Leanne M Munsie, Noam Y Kirson, Urvi Desai, Erich J Trieschman, Mark K Meiselbach, J Scott Andrews, Malaz A Boustani
OBJECTIVES: To examine the effect of the Medicare Annual Wellness Visit (AWV) on the detection of cognitive impairment and on follow-up cognitive care for older adults. DESIGN: Retrospective matched-cohort study. SETTING: United States. PARTICIPANTS: A 5% random sample of fee-for-service Medicare beneficiaries continuously enrolled for 12 months before and after an index ambulatory visit occurring from 2011 to 2013 with no claims evidence of cognitive impairment before index...
April 2, 2018: Journal of the American Geriatrics Society
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