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https://www.readbyqxmd.com/read/29790923/missed-opportunities-to-prescribe-preexposure-prophylaxis-in-south-carolina-2013-2016
#1
Dawn K Smith, Man-Huei Chang, Wayne A Duffus, Stella Okoye, Sharon Weissman
Introduction: Expanding use of preexposure prophylaxis (PrEP) in ways that address current racial/ethnic disparities is an important HIV prevention goal. We investigated missed opportunities to provide PrEP during healthcare visits occurring prior to HIV infection. Methods: This retrospective cohort study linked South Carolina HIV case surveillance data to 3 statewide healthcare databases. Characteristics of patients, health care visits and providers, sexually transmitted diseases (STD), and other diagnoses, were assessed for medical encounters occurring before an initial HIV diagnosis...
May 22, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29786592/obstetric-and-gynecological-care-by-family-doctors-in-ukraine-literature-review
#2
Oksana V Bakun, Svitlana Y Karatieieva, Svitlana B Semenenko, Oksana I Yurkiv, Ksenia V Slobodian
OBJECTIVE: Introduction: The analysis of literature on the questions of obstetrical and gynecologic care by general practitioners - family doctors in Ukraine has been presented in the article. Special attention has been paid to the actual problems of primary health care implementation on the basis of family medicine. The aim of the study is to find out the depth of the problem "A female doctor as an obstetrician-gynecologist" by analyzing scientific relevant literature data...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29781693/collaborative-postgraduate-training-in-family-medicine-and-primary-care-reflections-on-my-visit-to-south-africa
#3
Felicity Goodyear-Smith
This reflection describes my funded visit to South Africa to assist in primary care research capacity building as Chair, WONCA Working Party on Research (WP-R). The trip included time at the Universities of Walter Sisulu, Limpopo and Stellenbosch to mentor postgraduate students working on master's and PhD theses. I held one-on-one and group sessions and ran interactive scientific writing workshops. I assisted with the establishment of a Stellenbosch University Family Physician Research Network of faculty academics and family physicians (FP) which will generate research questions from community stakeholders...
April 26, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29768977/primary-care-physicians-perceptions-of-practice-improvement-as-a-professional-responsibility-a-cross-sectional-study
#4
Christopher R Stephenson, Christopher M Wittich, Joel E Pacyna, Matthew K Wynia, Omar Hasan, Jon C Tilburt
Continuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians' perceptions of the practice improvement (Part IV) components of MOC. We aimed to determine primary care physicians' perceptions of their professional responsibility to participate in Part IV MOC. This was a cross-sectional study of primary care physicians using the American Medical Association Masterfile...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#5
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29746221/interprofessional-population-health-advocacy-developing-and-implementing-a-panel-management-curriculum-in-five-veterans-administration-primary-care-practices
#6
Maya Dulay, Judith L Bowen, William G Weppner, Abigail Eastburn, Anne P Poppe, Pete Spanos, Danielle Wojtaszek, Destiny Printz, Catherine P Kaminetzky
Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort...
May 10, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29730617/what-is-the-epidemiology-of-medication-errors-error-related-adverse-events-and-risk-factors-for-errors-in-adults-managed-in-community-care-contexts-a-systematic-review-of-the-international-literature
#7
Ghadah Asaad Assiri, Nada Atef Shebl, Mansour Adam Mahmoud, Nouf Aloudah, Elizabeth Grant, Hisham Aljadhey, Aziz Sheikh
OBJECTIVE: To investigate the epidemiology of medication errors and error-related adverse events in adults in primary care, ambulatory care and patients' homes. DESIGN: Systematic review. DATA SOURCE: Six international databases were searched for publications between 1 January 2006 and 31 December 2015. DATA EXTRACTION AND ANALYSIS: Two researchers independently extracted data from eligible studies and assessed the quality of these using established instruments...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29730609/appropriately-testing-patients-with-intermediate-risk-for-coronary-artery-disease-how-well-are-we-doing
#8
Ali A Alsaad, Brian P Shapiro
BACKGROUND: Cardiovascular risk assessment and stratification of stable coronary artery disease represents a pivotal component of coronary artery disease management. The introduction of risk stratification tools has advanced the detection of patients with intermediate to high risk for coronary artery events. These patients will ultimately undergo non-invasive and invasive cardiovascular testing. OBJECTIVE: To synthesise evidence illustrating risk stratification tools and non-invasive testing for patients with intermediate risk for coronary artery disease and suggest a simple method for clinicians to follow prior to ordering non-invasive cardiovascular testing...
May 5, 2018: BMJ evidence-based medicine
https://www.readbyqxmd.com/read/29701431/-current-developments-in-parkinson-s-disease
#9
Benoit Wicki, David Benninger
Our understanding of Parkinson's disease has considerably evolved in the last few years. While the cardinal motor features bradykinesia, rigidity, and tremor define the disease and respond to dopamine replacement therapy, there is a wider-spread neurodegeneration causing non motor symptoms and their impact on the quality of life of patients is being increasingly recognized. The follow-up requires a good collaboration between primary care physicians and neurologists. The purpose of this article is to offer a practical treatment guide of uncomplicated Parkinson's disease for general practitioners and internal medicine specialists...
April 25, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29700790/impact-of-medical-scribes-on-physician-and-patient-satisfaction-in-primary-care
#10
Anastasia Pozdnyakova, Neda Laiteerapong, Anna Volerman, Lauren D Feld, Wen Wan, Deborah L Burnet, Wei Wei Lee
BACKGROUND: Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. OBJECTIVE: Assess the impact of a scribe on physician and patient satisfaction at an academic general internal medicine (GIM) clinic. DESIGN: Prospective, pre-post-pilot study. During the 3-month pilot, physicians had clinic sessions with and without a scribe...
April 26, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29699717/-effectiveness-of-a-new-model-of-telephone-derivation-shared-between-primary-care-and-hospital-care
#11
Luis Miguel Azogil-López, Juan José Pérez-Lázaro, Patricia Ávila-Pecci, Esther María Medrano-Sánchez, María Valle Coronado-Vázquez
AIM: The purpose of this study is to find out whether telephone referral from Primary Health Care to Internal Medicine Consult manages to reduce waiting days as compared to traditional referral. This study also aims to know how acceptable is the telephone referral to general practitioners and their patients. DESIGN: No blind randomized controlled clinical trial. SETTING: Northern Huelva Health District. PARTICIPANTS: 154 patients...
April 23, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29695262/hypericum-perforatum-to-improve-post-operative-pain-outcome-after-monosegmental-spinal-microdiscectomy-hypos-a-study-protocol-for-a-randomised-double-blind-placebo-controlled-trial
#12
Christa Raak, Wolfram Scharbrodt, Bettina Berger, Arndt Büssing, René Geißen, Thomas Ostermann
BACKGROUND: Spinal disc herniation is a frequently occurring degenerative disease of the spine. Many patients undergoing surgery suffer from radicular pain, known as memory pain, beginning from the third post-operative day. This results in the prescription of high-dose opioid medications. In homeopathy, Hypericum perforatum is known as a remedy for unbearable, shooting or jabbing pain especially when neural damage is involved. Reduction of pain after application of H. perforatum has been observed in previous studies...
April 25, 2018: Trials
https://www.readbyqxmd.com/read/29692932/intensive-care-unit-rotations-and-predictors-of-career-choice-in-pulmonary-critical-care-medicine-a-survey-of-internal-medicine-residency-directors
#13
Daniel J Minter, Sean D Levy, Sowmya R Rao, Paul F Currier
Background: The United States (US) is experiencing a growing shortage of critical care medicine (CCM) trained physicians. Little is known about the exposures to CCM experienced by internal medicine (IM) residents or factors that may influence their decision to pursue a career in pulmonary/critical care medicine (PCCM). Methods: We conducted a survey of US IM residency program directors (PDs) and then used multivariable logistic regression to identify factors that were predictive of residency programs with a higher percentage of graduates pursuing careers in PCCM...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29691756/prospective-evaluation-of-cardiac-ultrasound-performance-by-general-internal-medicine-physicians-during-a-6-month-faculty-development-curriculum
#14
Christopher J Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden, Tabatha Matthias
BACKGROUND: Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term outcomes, knowledge and skills rapidly decay without deliberate practice and feedback. The purpose of this study was to evaluate the performance of focused cardiac ultrasound (FCU) by volunteer general internal medicine (GIM) faculty participating in a longitudinal POCUS curriculum...
April 24, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29688856/physician-s-sociodemographic-profile-and-distribution-across-public-and-private-health-care-an-insight-into-physicians-dual-practice-in-brazil
#15
Bruno Alonso Miotto, Aline Gil Alves Guilloux, Alex Jones Flores Cassenote, Giulia Marcelino Mainardi, Giuliano Russo, Mário César Scheffer
BACKGROUND: The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country's medical workforce. Physicians' simultaneous engagement in public and private services is a common and unregulated practice in Brazil, but the influence played by contextual factors and personal characteristics over dual practice engagement are still poorly understood. This study aimed at exploring the sociodemographic profile of Brazilian physicians to shed light on the links between their personal characteristics and their distribution across public and private services...
April 23, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29686763/international-medical-graduates-in-the-us-physician-workforce-and-graduate-medical-education-current-and-historical-trends
#16
Awad A Ahmed, Wei-Ting Hwang, Charles R Thomas, Curtiland Deville
Background : Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective : We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods : We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29683840/enhancing-hiv-pre-exposure-prophylaxis-practices-via-an-educational-intervention
#17
Rebecca Newman, Tasleem Katchi, Michael Karass, Melissa Gennarelli, Jason Goutis, Alina Kifayat, Shantanu Solanki, Srikanth Yandrapalli, Leanne Forman, Christopher Nabors
BACKGROUND: Pre-exposure prophylaxis (PrEP) for HIV involves using antiretroviral drugs to prevent individuals at high risk from acquiring HIV infection. Most practicing primary care providers believe PrEP to be safe and effective, but less than half have prescribed or referred for PrEP. Attitudes and prescribing patterns among house officers have not been well described previously. STUDY QUESTION: Can an educational intervention enhance HIV PrEP practices among internal medicine house officers? STUDY DESIGN: This study relied on a pretest/posttest design...
April 20, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29681044/benefit-risk-of-patients-online-access-to-their-medical-records-consensus-exercise-of-an-international-expert-group
#18
Harshana Liyanage, Siaw-Teng Liaw, Emmanouela Konstantara, Freda Mold, Richard Schreiber, Craig Kuziemsky, Amanda L Terry, Simon de Lusignan
BACKGROUND:  Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. OBJECTIVE:  To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). METHOD:  A five-round Delphi study was conducted...
April 22, 2018: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29680814/spect-v-q-for-the-diagnosis-of-pulmonary-embolism-protocol-for-a-systematic-review-and-meta-analysis-of-diagnostic-accuracy-and-clinical-outcome
#19
Pierre-Yves Le Roux, Philippe Robin, Cécile Tromeur, Alexandra Davis, Helia Robert-Ebadi, Marc Carrier, Francis Couturaud, Grégoire Le Gal, Pierre-Yves Salaun
INTRODUCTION: Single photon emission computed tomography ventilation/perfusion (SPECT V/Q) imaging has many proponents within the nuclear medicine community and has already largely replaced planar V/Q scintigraphy in daily practice for the diagnosis of pulmonary embolism (PE). However, the test is still described in clinical guidelines as an experimental test because of insufficient evidence. METHODS AND ANALYSIS: We will conduct a systematic review and a meta-analysis of diagnostic accuracy and management outcome studies involving patients evaluated with V/Q SPECT for suspected acute PE...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#20
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
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