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https://www.readbyqxmd.com/read/29782269/-assessment-of-efficacy-of-combined-pharmacotherapy-with-fixed-perindopril-amlodipine-combination-in-patients-with-combined-cardiovascular-pathology-in-outpatient-practice
#1
E I Bezuglova, Y V Luneva, A A Kornilov, S V Povetkin
AIM: to study effects of using fixed perindopril/amlodipine combination in complex treatment of patients with combined cardiac pathology in active observation mode, in comparison with other angiotensin converting enzyme (ACE inhibitors) or angiotensin II receptor antagonists (ARA), including free combination with calcium channel blockers (CCB) in conditions of routine outpatient practice. MATERIALS AND METHODS: The design of the study included two stages: I - monitoring effectiveness of pharmacotherapy performed in routine outpatient practice (duration of 2 months), II - "active treatment (management)" - changing the pharmacotherapy scheme in patients who did not reach the target level of "office" blood pressure (BP), monitoring patients for 6 months and carrying out, if necessary, dose correction of the newly appointed treatment regimen...
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29779544/prescribing-practices-of-rural-physicians-waivered-to-prescribe-buprenorphine
#2
C Holly A Andrilla, Cynthia Coulthard, Davis G Patterson
INTRODUCTION: Opioid use disorder is a serious public health burden, especially throughout rural America. Although efforts have been made to increase the availability of buprenorphine (an office-based medication-assisted treatment), more than 60% of rural counties in the U.S. lack a physician with a Drug Enforcement Administration waiver to prescribe it. METHODS: This study surveyed all rural physicians with a Drug Enforcement Administration waiver in 2016 to prescribe buprenorphine for opioid use disorder in the U...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29774810/procedural-module-flexible-cystoscopy
#3
Shoaib Safiullah, Daniel J Lama, Roshan Patel, Ralph V Clayman
INTRODUCTION: Cystoscopy is a basic urologic skill necessary for the endoscopic evaluation of the urethra and bladder. Presented is a step-by-step guide for flexible cystoscopy of the male and female patient. MATERIALS/METHODS: Routine flexible cystoscopy was performed on a male patient with a history of upper tract urothelial carcinoma and a female patient as part of a hematuria evaluation. The male patient was positioned supine, and the female patient frog-leg supine...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29771745/national-institute-on-drug-abuse-international-program-improving-opioid-use-disorder-treatment-through-international-research-training
#4
Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29769096/a-methodology-for-generating-a-tailored-implementation-blueprint-an-exemplar-from-a-youth-residential-setting
#5
Cara C Lewis, Kelli Scott, Brigid R Marriott
BACKGROUND: Tailored implementation approaches are touted as more likely to support the integration of evidence-based practices. However, to our knowledge, few methodologies for tailoring implementations exist. This manuscript will apply a model-driven, mixed methods approach to a needs assessment to identify the determinants of practice, and pilot a modified conjoint analysis method to generate an implementation blueprint using a case example of a cognitive behavioral therapy (CBT) implementation in a youth residential center...
May 16, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29764891/developing-a-complex-intervention-to-support-timely-engagement-with-palliative-care-for-patients-with-advanced-cancer-in-primary-and-secondary-care-in-the-uk-a-study-protocol
#6
Julia Hackett, Hilary Bekker, Michael I Bennett, Paul Carder, Jean Gallagher, Claire Henry, Suzanne Kite, Sally Taylor, Galina Velikova, Lucy Ziegler
INTRODUCTION: For patients with advanced cancer, timely access to palliative care can improve quality of life and enable patients to participate in decisions about their end-of-life care. However, in a UK population of 2500 patients who died from cancer, one-third did not receive specialist palliative care, and of those who did, the duration of involvement was too short to maximise the benefits. Initiating a conversation about palliative care is challenging for some health professionals and patients often have unmet information needs and misconceptions about palliative care...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29763275/general-parenting-strategies-practical-suggestions-for-common-child-behavior-issues
#7
Michael G Kavan, Shailendra K Saxena, Naureen Rafiq
Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and assist parents by providing effective monitoring tools for behavior problems. Effective strategies for influencing a child's behavior include positive reinforcement to increase appropriate behavior, extinction (planned ignoring) for most low-level problematic behaviors, and time-out from reinforcement for more problematic behaviors...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29759262/focus-on-the-quadruple-aim-development-of-a-resiliency-center-to-promote-faculty-and-staff-wellness-initiatives
#8
Ellen Morrow, Megan Call, Robin Marcus, Amy Locke
DEFINING THE PROBLEM: A growing body of evidence highlights the need for wellness programs to support health care professionals. Although much of the existing literature centers on practicing physicians and physician trainees, there is growing awareness that these challenges are not unique to physicians and affect all members of the health care team. Traumatic and stressful events will always be a part of health care; how these events are addressed on a personal and team level is essential to the success of a health care system...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29759261/deriving-a-framework-for-a-systems-approach-to-agitated-patient-care-in-the-emergency-department
#9
Ambrose H Wong, Halley Ruppel, Lauren J Crispino, Alana Rosenberg, Joanne D Iennaco, Federico E Vaca
BACKGROUND: The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. METHODS: A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#10
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29757941/exploring-how-the-home-environment-influences-eating-and-physical-activity-habits-of-low-income-latino-children-of-predominantly-immigrant-families-a-qualitative-study
#11
Ana Cristina Lindsay, Sherrie F Wallington, Faith D Lees, Mary L Greaney
Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and maintains dietary and physical activity (PA) habits that ultimately impact weight status. Previous research suggests the parents are central to creating a home environment that facilitates or hinders the development of children’s early healthy eating and PA habits...
May 14, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29757820/longitudinal-study-of-advanced-practice-nurses-implementation-of-screening-intervals-for-cervical-cancer-screening
#12
Joyce D Cappiello, Maureen Boardman
BACKGROUND AND PURPOSE: The past two decades brought changes in cervical cancer screening guidelines. Frequent modifications and earlier lack of agreement about recommendations created confusion. The purpose of this study was to explore to what extent advanced practice nurses (APNs) adopted cervical cancer screening guidelines. METHODS: A longitudinal survey of 358 APNs conducted in three New England states regarding cervical cancer screening practices in 2008, 2012, and 2015...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757788/the-primary-care-provider-and-the-patient-living-in-poverty-applying-the-bridges-to-health-and-healthcare-model-to-np-practice
#13
Barbara Wise, Terie Dreussi-Smith
BACKGROUND AND PURPOSE: There is a much recent emphasis on the social determinants of health, and poverty is the most influential of these. It is not enough merely to understand the influence of poverty on health-the primary care provider must understand how to effectively treat patients who live in poverty. METHODS: This article applies the Bridges to Health and Healthcare model for understanding poverty to primary care practice from an individual provider's perspective...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29756745/controversies-in-office-based-anesthesia-obstructive-sleep-apnea-considerations
#14
Ruchir Gupta, Srinivas Pyati
As the number of procedures being performed in the office based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these patients can be safely cared for in the OBA setting. To date, no national guideline has clearly addressed this issue and while some have extrapolated lessons from what has been published for OSA in the ambulatory surgery center (ASC) setting, some argue that there is a significant difference in the availability of resources in the ASC versus the OBA setting...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29748913/efficacy-and-tolerability-of-fixed-dose-combination-perindopril-indapamide-in-hypertensive-patients-with-a-history-of-stroke-or-transient-ischemic-attack-picasso-trial
#15
Csaba András Dézsi, Csaba Farsang
INTRODUCTION: In everyday medical practice, physicians often need to manage patients whose blood pressure is not well controlled. Those with a history of cerebrovascular disease are a high-risk group in need of rapid blood pressure control. METHODS: The PICASSO study was a real-life, observational trial involving 9257 inadequately treated hypertensive patients who were switched from previous therapy to the fixed-dose combination of perindopril 10 mg/indapamide 2...
May 10, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29747862/the-effect-of-insurance-type-on-access-to-inguinal-hernia-repair-under-the-affordable-care-act
#16
Walter Hsiang, Catherine McGeoch, Sarah Lee, William Cheung, Robert Becher, Kimberly A Davis, Kevin M Schuster
BACKGROUND: The expansion of Medicaid under the Affordable Care Act extended coverage to any individual with an income up to 138% of the federal poverty level. Our study of surgeon practice management investigated the impact of the type of insurance on access to elective inguinal hernia repair and the disparities in access between Medicaid expansion and nonexpansion states. METHODS: Practices of 240 hernia repair surgeons across 8 states were randomly selected from the American College of Surgeons Find a Surgeon Database...
May 7, 2018: Surgery
https://www.readbyqxmd.com/read/29743932/timely-initiation-of-breastfeeding-and-associated-factors-among-mothers-of-infants-under-12-months-in-south-gondar-zone-amhara-regional-state-ethiopia-2013
#17
Liyew Mekonen, Wubareg Seifu, Zemenu Shiferaw
Background: Timely initiation of breastfeeding is defined as putting the newborn to the breast within one hour of birth. Significant benefits in reducing neonatal mortality and morbidity can be attained with effective promotion of timely initiation of breastfeeding and exclusive breastfeeding during the first months of life. Therefore, this study was conducted to assess timely initiation of breastfeeding and associated factors among mothers in South Gondar, Amhara regional state, Northern Ethiopia...
2018: International Breastfeeding Journal
https://www.readbyqxmd.com/read/29743219/clinician-experiences-with-screening-for-social-needs-in-primary-care
#18
Sebastian T Tong, Winston R Liaw, Paulette Lail Kashiri, James Pecsok, Julia Rozman, Andrew W Bazemore, Alex H Krist
BACKGROUND: Despite clear evidence demonstrating the influence of social determinants on health, whether and how clinicians should address these determinants remain unclear. We aimed to understand primary care clinicians' experiences of administering a social needs screening instrument. METHODS: Using a prospective, observational design, we identified patients living in communities with lower education and income seen by 17 clinicians from 12 practices in northern Virginia...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29740815/screening-for-dysglycaemia-in-dental-primary-care-practice-settings-systematic-review-of-the-evidence
#19
REVIEW
Ingrid Glurich, Barbara Bartkowiak, Richard L Berg, Amit Acharya
INTRODUCTION: Increasing prevalence of diabetes and periodontal disease is prompting identification of additional clinical settings to identify patients at risk for dysglycaemia. A systematic review of studies that have examined feasibility of screening for at-risk patients in general dentistry settings at point-of-care (POC) was undertaken. MATERIALS AND METHODS: Systematic review of pragmatic clinical field trials piloting POC screening for dysglycaemia risk in dental settings was undertaken in studies whose primary objective was to explore rates of dysglycaemia among undiagnosed patient populations...
May 8, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29739392/clinicians-perceptions-of-usefulness-of-the-pubmed4hh-mobile-device-application-for-clinical-decision-making-at-the-point-of-care-a-pilot-study
#20
Kyungsook Gartrell, Caitlin W Brennan, Gwenyth R Wallen, Fang Liu, Karen G Smith, Paul Fontelo
BACKGROUND: Although evidence-based practice in healthcare has been facilitated by Internet access through wireless mobile devices, research on the effectiveness of clinical decision support for clinicians at the point of care is lacking. This study examined how evidence as abstracts and the bottom-line summaries, accessed with PubMed4Hh mobile devices, affected clinicians' decision making at the point of care. METHODS: Three iterative steps were taken to evaluate the usefulness of PubMed4Hh tools at the NIH Clinical Center...
May 8, 2018: BMC Medical Informatics and Decision Making
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