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https://www.readbyqxmd.com/read/28820951/lactation-consultants-perceived-barriers-to-providing-professional-breastfeeding-support
#1
Erica H Anstey, Martha Coulter, Cecilia M Jevitt, Kay M Perrin, Sharon Dabrow, Lynne B Klasko-Foster, Ellen M Daley
BACKGROUND: Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. METHODS: This qualitative study was conducted with a grounded theory methodological approach...
August 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28817791/using-practice-facilitation-to-increase-rates-of-colorectal-cancer-screening-in-community-health-centers-north-carolina-2012-2013-feasibility-facilitators-and-barriers
#2
Bryan J Weiner, Catherine L Rohweder, Jennifer E Scott, Randall Teal, Alecia Slade, Allison M Deal, Naima Jihad, Marti Wolf
INTRODUCTION: Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina. METHODS: The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28816992/are-physician-assistants-needed-in-guatemala-a-survey-of-potential-urban-and-rural-users
#3
Claudia Luna-Asturias, Jennifer Apple, Guillermo A Bolaños, Jonathan M Bowser, Edwin J Asturias
PURPOSE: The shortage of trained health care personnel has been increasing worldwide. With the physician assistant (PA) profession, created in the United States in the 1960s, expanding globally, this study sought to ascertain whether PAs can be an innovative solution to this crisis. METHODS: We conducted a convenience sample survey to assess the need for and acceptability of future PA professionals in Guatemala. Eighty-nine doctors, nurses, and community members from rural and urban areas of Guatemala participated in the survey...
September 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28816914/congenital-hypotonia-in-toddlerhood
#4
Naomi Steiner, Alcy Torres, Arathi Reddy, Marilyn Augustyn
David is a 22-month-old boy who is new to your practice. He recently moved from a rural area in the Midwest. His father is in the United States Air Force, and his mother works as a full-time homemaker. Their household includes 5 older siblings. The family moves every year because of the father's Air Force placement.David was born full-term in Virginia, with no reported pregnancy complications and no alcohol, tobacco, or drug exposure. He was delivered vaginally, with Apgar scores of 7 and 9, respectively and no respiratory issues...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28816539/non-operative-management-of-differentiated-thyroid-cancer-in-california-a-population-level-analysis-of-29-978-patients
#5
Eric J Kuo, James X Wu, Ning Li, Kyle A Zanocco, Michael W Yeh, Masha J Livhits
OBJECTIVE: There has been increasing interest in active surveillance of papillary thyroid microcarcinoma (mPTC). The objective of this study was to characterize the incidence and outcomes of non-operatively managed differentiated thyroid cancers (DTCs) in California. METHODS: Biopsy-proven DTCs from the California Cancer Registry (CCR) were linked to data from the California Office of Statewide Health Planning and Development (2004-2012). Low-risk tumors were defined as localized disease measuring < 4 cm without extrathyroidal extension, nodal involvement, or distant metastasis...
August 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28815132/precision-diagnosis-of-melanoma-and-other-skin-lesions-from-digital-images
#6
Abhishek Bhattacharya, Albert Young, Andrew Wong, Simone Stalling, Maria Wei, Dexter Hadley
Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28812813/do-management-and-leadership-practices-in-the-context-of-decentralisation-influence-performance-of-community-health-fund-evidence-from-iramba-and-iringa-districts-in-tanzania
#7
Chakupewa Joseph, Stephen Oswald Maluka
BACKGROUND: In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts...
September 26, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28811907/factors-associated-with-antibiotic-prescriptions-for-the-viral-origin-diseases-in-office-based-practices-2006-2012
#8
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
#9
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/28810988/association-between-personal-protective-equipment-use-and-injury-occurrence-among-the-republic-of-korea-armed-forces
#10
Tae Kyung Kim, Byung-Chan Jeon, Eunkyoung Bae, Kyoung Ki Bae, Kyu-Tae Han, Eun-Cheol Park
INTRODUCTION: Soldiers are at a higher risk of injury than people of other occupations. To date, no studies have examined the association between injury and personal protective equipment (PPE) use in the Republic of Korea (ROK) military. Thus, this study aimed to investigate possible associations between injury and PPE use in military personnel. In addition, we aimed to identify the possible interactions between injury and PPE use according to military personnel characteristics. MATERIALS AND METHODS: We used secondary data from the 2014-2015 Military Health Survey...
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
#11
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/28808077/gps-knowledge-use-and-confidence-in-national-physical-activity-and-health-guidelines-and-tools-a-questionnaire-based-survey-of-general-practice-in-england
#12
Robin Chatterjee, Tim Chapman, Mike Gt Brannan, Justin Varney
BACKGROUND: Physical activity (PA) brief advice in health care is effective at getting individuals active. It has been suggested that one in four people would be more active if advised by a GP or nurse, but as many as 72% of GPs do not discuss the benefits of physical activity with patients. AIM: To assess the knowledge, use, and confidence in national PA and Chief Medical Officer (CMO) health guidelines and tools among GPs in England. DESIGN AND SETTING: Online questionnaire-based survey of selfselecting GPs in England that took place over a 10-day period in March 2016...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28807959/referral-processes-and-wait-times-in-primary-care
#13
Ieva Neimanis, Kathryn Gaebel, Robert Dickson, Richard Levy, Cindy Goebel, Angelo Zizzo, Anne Woods, John Corsini
OBJECTIVE: To evaluate the response times to requests for consultations from FPs and the wait times for patient appointments. DESIGN: Mailed invitation to participate in a survey about non-FP specialist consultation requests from April 28 to May 9, 2014. SETTING: Hamilton, Ont. PARTICIPANTS: All active physicians with community practices from the Department of Family Medicine at St Joseph's Healthcare Hamilton and Hamilton Health Sciences...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28807881/taking-the-initiative-risk-reduction-strategies-and-decreased-malpractice-costs
#14
Steven E Raper, Deborah Rose, Mary Ellen Nepps, Jeffrey A Drebin
BACKGROUND: To heighten awareness of attending and resident surgeons regarding strategies for defense against malpractice claims, a series of Risk Reduction Initiatives (Initiatives) have been carried out in our Department of Surgery (Surgery). We hypothesized that emphasis on certain aspects of risk might be associated with decreased malpractice costs. The relative impact of Surgery Initiatives was assessed when compared to malpractice experience for the rest of the Clinical Practices of the University of Pennsylvania (CPUP)...
August 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28807536/effectiveness-of-household-lockable-pesticide-storage-to-reduce-pesticide-self-poisoning-in-rural-asia-a-community-based-cluster-randomised-controlled-trial
#15
Melissa Pearson, Chris Metcalfe, Shaluka Jayamanne, David Gunnell, Manjula Weerasinghe, Ravi Pieris, Chamil Priyadarshana, Duleeka W Knipe, Keith Hawton, Andrew H Dawson, Palitha Bandara, Dhammika deSilva, Indika Gawarammana, Michael Eddleston, Flemming Konradsen
BACKGROUND: Agricultural pesticide self-poisoning is a major public health problem in rural Asia. The use of safer household pesticide storage has been promoted to prevent deaths, but there is no evidence of effectiveness. We aimed to test the effectiveness of lockable household containers for prevention of pesticide self-poisoning. METHODS: We did a community-based, cluster-randomised controlled trial in a rural area of North Central Province, Sri Lanka. Clusters of households were randomly assigned (1:1), with a sequence computer-generated by a minimisation process, to intervention or usual practice (control) groups...
August 11, 2017: Lancet
https://www.readbyqxmd.com/read/28803811/office-operative-hysteroscopy-an-update
#16
REVIEW
Christina Alicia Salazar, Keith Isaacson
Hysteroscopy is considered the gold standard for evaluation of intracavitary pathology associated with both pre- and postmenopausal patients with abnormal uterine bleeding as well as part of the evaluation of infertility patients with suspected cavity abnormalities. Office-based operative hysteroscopy allows patients to resume activities immediately and successfully integrates clinical practice into a "see and treat" modality, avoiding the added risks of undergoing anesthesia and the inconvenience of going to the operating room...
August 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28802210/the-adoption-of-children-from-out-of-home-care-the-understandings-of-key-decision-makers-in-victoria-australia
#17
Anna Butlinski, Heather Rowe, Christopher Goddard, Nicholas Freezer
Adoption is one of a range of options that can provide children in out-of-home care with permanency when they are unable to be reunified with their birth parents. This paper reports on how the adoption of children from out-of-home care is understood by professionals involved in making decisions about the permanent placement of children in out-of-home care in Victoria, Australia, where adoption is rarely used. Data were collected through a single, face-to-face semi-structured interview with 21 professionals; eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers...
August 8, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#18
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28798502/reducing-the-environmental-impact-of-clinical-laboratories
#19
Joseph B Lopez, David Jackson, Alistair Gammie, Tony Badrick
Healthcare is a significant contributor to environmental impact but this has received little attention. The typical laboratory uses far more energy and water per unit area than the typical office building. There is a need to sensitise laboratories to the importance of adopting good environmental practices. Since this comes at an initial cost, it is vital to obtain senior management support. Convincing management of the various tangible and intangible benefits that can accrue in the long run should help achieve this support...
February 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28797923/opportunity-for-interprofessional-collaborative-care-findings-from-a-sample-of-federally-qualified-health-center-patients-in-the-midwest
#20
L J Smith, V Johnson-Lawrence, M Andrews, S Parker
OBJECTIVES: Federally qualified health centers (FQHCs) frequently serve more socio-economically disadvantaged populations; existing literature suggests that underserved groups are more likely to experience various chronic physical and mental health conditions. FQHC patients may have significant needs for various specialty services that are beyond common FQHC providers. This study examines chronic condition prevalence, healthcare satisfaction, and use of multiprovider services in a Midwest FQHC patient population...
August 7, 2017: Public Health
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