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https://www.readbyqxmd.com/read/29332263/creating-a-primary-care-workforce-strategies-for-leaders-clinicians-and-nurses
#1
Patricia Robinson, Julie Oyemaja, Bridget Beachy, Jeff Goodie, Lisa Sprague, Jennifer Bell, Mike Maples, Christy Ward
Many primary care clinics struggle with rapid implementation and systematic expansion of primary care behavioral health (PCBH) services. Often, an uneven course of program development is due to lack of attention to preparing clinic leadership, addressing operational factors, and training primary care providers (PCPs) and nurses. This article offers competency tools for clinic leaders, PCPs, and nurses to use in assessing their status and setting change targets. These tools were developed by researchers working to disseminate evidence-based interventions in primary care clinics that included fully integrated behavioral health consultants and were then used by early adaptors of the PCBH model...
January 13, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29332169/measuring-cochlear-duct-length-in-asian-population-worth-giving-a-thought
#2
Mohnish Grover, Shitanshu Sharma, Shashank Nath Singh, Tanmaya Kataria, Rajendra Singh Lakhawat, Man Prakash Sharma
INTRODUCTION: The anatomy of the cochlea forms the basis for a successful cochlear implantation. Cochlear duct length (CDL) is defined as the length of the scala media as measured from the middle of the round window to helicotrema. Preoperative measurement of CDL is particularly important when precise intracochlear electrode array placement is desired. It can be done both histologically and radiologically. Preoperative high-resolution computed tomography (HRCT) scan which forms an integral part of cochlear implant workup is a useful tool to calculate CDL using 3D reconstructions...
January 13, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29332023/autonomic-response-testing-compared-with-immunoglobulin-e-allergy-panel-test-results-preliminary-report
#3
Autumn Frandsen, Mark McClure, Myung Kyu Chung, Patrick J LaRiccia
Context • Chronically ill patients who have failed standard medical assessment and therapies are often assessed by integrative medical providers for atypical manifestations of allergies as the possible source or contributing factor(s) to their condition. Skin testing and immunoglobulin E (IgE) allergy panels increase the cost of care in these patients. Objective • The objective of this study was to determine the accuracy of autonomic response testing (ART) as compared with IgE allergy panel blood tests...
January 15, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29331971/a-study-protocol-for-a-non-randomised-comparison-trial-evaluating-the-feasibility-and-effectiveness-of-a-mobile-cognitive-behavioural-programme-with-integrated-coaching-for-anxious-adults-in-primary-care
#4
Eva Szigethy, Francis Solano, Meredith Wallace, Dina L Perry, Lauren Morrell, Kathryn Scott, Megan Jones Bell, Megan Oser
INTRODUCTION: Generalised anxiety disorder (GAD) and subclinical GAD are highly prevalent in primary care. Unmanaged anxiety worsens quality of life in patients seen in primary care practices and leads to increased medical utilisation and costs. Programmes that teach patients cognitive-behavioural therapy (CBT) techniques have been shown to improve anxiety and to prevent the evolution of anxiety symptoms to disorders, but access and engagement have hampered integration of CBT into medical settings...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331967/understanding-frailty-a-qualitative-study-of-european-healthcare-policy-makers-approaches-to-frailty-screening-and-management
#5
Holly Gwyther, Rachel Shaw, Eva-Amparo Jaime Dauden, Barbara D'Avanzo, Donata Kurpas, Maria Bujnowska-Fedak, Tomasz Kujawa, Maura Marcucci, Antonio Cano, Carol Holland
OBJECTIVE: To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. DESIGN: Thematic analysis of semistructured qualitative interviews. SETTING: European healthcare policy departments. PARTICIPANTS: Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#6
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331534/perinatal-palliative-care-integration-in-a-united-states-nurse-midwifery-education-program
#7
Jenna A LoGiudice, Eileen O'Shea
Midwifery students with perinatal palliative care education develop a skillset to provide holistic midwifery care to women and families who are experiencing stillbirth or life-limiting fetal diagnoses. This paper presents a model of perinatal palliative care in a United States midwifery education program. By utilizing evidence based practices and national programs, perinatal palliative care can be threaded through midwifery curricula to achieve international standards of practice and competencies. Most importantly, enhancing perinatal palliative care education will better prepare future midwives for when a birth outcome is not what was expected at the outset of a pregnancy...
December 28, 2017: Midwifery
https://www.readbyqxmd.com/read/29331530/a-qualitative-synthesis-of-pharmacist-other-health-professional-and-lay-perspectives-on-the-role-of-community-pharmacy-in-facilitating-care-for-people-with-long-term-conditions
#8
N J Hall, G Donovan, S Wilkes
BACKGROUND: There is increasing interest in an enhanced role for community pharmacy (CP) in facilitating care for people with long-term conditions (LTCs). It is important to understand the perspectives of stakeholders in order to identify key issues that may impact on future development of the role and related services. OBJECTIVES: Explore pharmacist, other health professional and lay perspectives on the role of CP in facilitating care for people with LTCs. METHODS: Synthesis of qualitative research from UK based studies published between 2007 and January 2017 using a meta-ethnographic interpretative approach...
January 4, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29331430/disposable-inkjet-printed-electrochemical-platform-for-detection-of-clinically-relevant-her-2-breast-cancer-biomarker
#9
Susanita Carvajal, Samantha N Fera, Abby L Jones, Thaisa A Baldo, Islam M Mosa, James F Rusling, Colleen E Krause
Rapidly fabricated, disposable sensor platforms hold tremendous promise for point-of-care detection. Here, we present an inexpensive (< $0.25) fully inkjet printed electrochemical sensor with integrated counter, reference, and working electrodes that is easily scalable for commercial fabrication. The electrochemical sensor platform featured an inkjet printed gold working 8-electrode array (WEA) and counter electrode (CE), along with an inkjet -printed silver electrode that was chlorinated with bleach to produce a Ag/AgCl quasi-reference electrode (RE)...
January 4, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29331355/contemporary-procedural-complications-hospitalizations-and-emergency-visits-after-catheter-ablation-for-atrial-fibrillation
#10
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29330606/the-associations-of-poor-psychiatric-well-being-among-incarcerated-men-with-injecting-drug-use-histories-in-victoria-australia
#11
Reece Cossar, Mark Stoové, Stuart A Kinner, Paul Dietze, Campbell Aitken, Michael Curtis, Amy Kirwan, James R P Ogloff
BACKGROUND: Dual substance dependence and psychiatric and psychological morbidities are overrepresented in prison populations and associated with reoffending. In the context of an increasing prison population in Australia, investigating the needs of vulnerable people in prison with a dual diagnosis can help inform in-prison screening and treatment and improve prison and community service integration and continuation of care. In this study we quantified psychiatric well-being in a sample of people in prison with a history of injecting drug use in Victoria, Australia, and identified factors associated with this outcome...
January 13, 2018: Health & Justice
https://www.readbyqxmd.com/read/29330466/target-engagement-imaging-of-parp-inhibitors-in-small-cell-lung-cancer
#12
Brandon Carney, Susanne Kossatz, Benjamin H Lok, Valentina Schneeberger, Kishore K Gangangari, Naga Vara Kishore Pillarsetty, Wolfgang A Weber, Charles M Rudin, John T Poirier, Thomas Reiner
Insufficient chemotherapy response and rapid disease progression remain concerns for small-cell lung cancer (SCLC). Oncologists rely on serial CT scanning to guide treatment decisions, but this cannot assess in vivo target engagement of therapeutic agents. Biomarker assessments in biopsy material do not assess contemporaneous target expression, intratumoral drug exposure, or drug-target engagement. Here, we report the use of PARP1/2-targeted imaging to measure target engagement of PARP inhibitors in vivo. Using a panel of clinical PARP inhibitors, we show that PARP imaging can quantify target engagement of chemically diverse small molecule inhibitors in vitro and in vivo...
January 12, 2018: Nature Communications
https://www.readbyqxmd.com/read/29330247/frequency-and-criticality-of-diagnoses-in-family-medicine-practices-from-the-national-ambulatory-medical-care-survey-namcs
#13
Michael R Peabody, Thomas R O'Neill, Keith L Stelter, James C Puffer
BACKGROUND: Family medicine is a specialty of breadth, providing comprehensive health care for the individual and the family that integrates the broad scope of clinical, social, and behavioral sciences. As such, the scope of practice (SOP) for family medicine is extensive; however, over time many family physicians narrow their SOP. We sought to provide a nationally representative description of the most common and the most critical diagnoses that family physicians see in their practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#14
Amelia Sattler, Tracy Rydel, Cathina Nguyen, Steven Lin
PURPOSE: The immense clerical burden felt by physicians is one of the leading causes of burnout. Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. METHODS: Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#15
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330009/the-almanach-project-preliminary-results-and-potentiality-from-afghanistan
#16
A Bernasconi, F Crabbé, R Rossi, I Qani, A Vanobberghen, M Raab, S Du Mortier
INTRODUCTION: ALMANACH (ALgorithms for the MANagement of Acute CHildhood illnesses) is an electronic version of IMCI (Integrated Management of Childhood Illness) running on tablets. ALMANACH enhances its concept, it integrates well into health staff's daily consultation work and facilitates diagnosis and treatment. ALMANACH informs when to refer a child or to perform a rapid diagnostic test (RDT), recommends the right treatment dosage and synchronizes collected data real time with a Health Management Information System (DHIS2) for epidemiological evaluation and decision making...
December 28, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29329571/environmental-exposures-and-fetal-growth-the-haifa-pregnancy-cohort-study
#17
Rachel Golan, Itai Kloog, Ronit Almog, Anat Gesser-Edelsburg, Maya Negev, Maya Jolles, Varda Shalev, Vered H Eisenberg, Gideon Koren, Wiessam Abu Ahmad, Hagai Levine
BACKGROUND: The developing fetus is susceptible to environmental insults. Studying the effects of environmental exposures on fetal growth is essential for understanding the causal pathway between prenatal exposures and pregnancy outcomes. Here we describe the Haifa Pregnancy Cohort Study (HPCS) and discuss challenges and opportunities in applying "big data" paradigm. METHODS: Maccabi Healthcare Services (MHS), is the second largest Israeli health maintenance organization (HMO) providing care services to two million beneficiaries...
January 12, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29329456/designing-and-evaluating-an-automated-system-for-real-time-medication-administration-error-detection-in-a-neonatal-intensive-care-unit
#18
Yizhao Ni, Todd Lingren, Eric S Hall, Matthew Leonard, Kristin Melton, Eric S Kirkendall
Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Methods: Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period...
January 10, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29329386/the-role-of-service-readiness-and-health-care-facility-factors-in-attrition-from-option-b-in-haiti-a-joint-examination-of-electronic-medical-records-and-service-provision-assessment-survey-data
#19
Lauren Lipira, Christopher Kemp, Jean Wysler Domercant, Jean Guy Honoré, Kesner Francois, Nancy Puttkammer
Background: Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. Methods: This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment...
January 10, 2018: International Health
https://www.readbyqxmd.com/read/29329310/medication-discrepancies-across-multiple-care-transitions-a-retrospective-longitudinal-cohort-study-in-italy
#20
Marco Bonaudo, Maria Martorana, Valerio Dimonte, Alessandra D'Alfonso, Giulio Fornero, Gianfranco Politano, Maria Michela Gianino
PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions...
2018: PloS One
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