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https://www.readbyqxmd.com/read/29667375/core-curriculum-to-facilitate-the-expansion-of-a-rheumatology-practice-to-include-nurse-practitioners-and-physician-assistants
#1
Benjamin J Smith, Marcy B Bolster, Barbara Slusher, Christine Stamatos, Jeanne R Scott, Heather Benham, Salahuddin Kazi, Elizabeth A Schlenk, Daniel E Schaffer, Vikas Majithia, Calvin R Brown, Joan M von Feldt, Joseph Flood, David M Haag, Karen L Smarr
OBJECTIVE: Due to an aging population, increasing prevalence of rheumatic disease, and a growing supply and demand gap of rheumatology providers, innovative solutions are needed to meet the needs of persons with rheumatic conditions. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as a group of health professionals who could help address the workforce shortage. The Executive Committee of the Association of Rheumatology Health Professionals (ARHP), a division of the American College of Rheumatology (ACR), charged a task force to facilitate the preparation of NPs/PAs to work in a rheumatology practice setting...
April 17, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29667017/underestimated-prevalence-of-heart-failure-in-hospital-inpatients-a-comparison-of-icd-codes-and-discharge-letter-information
#2
Mathias Kaspar, Georg Fette, Gülmisal Güder, Lea Seidlmayer, Maximilian Ertl, Georg Dietrich, Helmut Greger, Frank Puppe, Stefan Störk
BACKGROUND: Heart failure is the predominant cause of hospitalization and amongst the leading causes of death in Germany. However, accurate estimates of prevalence and incidence are lacking. Reported figures originating from different information sources are compromised by factors like economic reasons or documentation quality. METHODS: We implemented a clinical data warehouse that integrates various information sources (structured parameters, plain text, data extracted by natural language processing) and enables reliable approximations to the real number of heart failure patients...
April 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29664672/primary-care-physicians-can-comprehensively-manage-sleep-apnea-patients-a-non-inferiority-randomized-controlled-trial
#3
M Ángeles Sánchez-Quiroga, Jaime Corral, Francisco J Gómez-de-Terreros, Carmen Carmona-Bernal, M Isabel Asensio-Cruz, Marta Cabello, M Ángeles Martínez-Martínez, Carlos J Egea, Estrella Ordax, Ferran Barbe, Javier Barca, Juan F Masa
RATIONALE: General practitioners play a passive role in obstructive sleep apnea (OSA) management. Simplification of the diagnosis and use of a semi-automatic algorithm for treatment can facilitate the integration of general practitioners, which has cost advantages. OBJECTIVE: To determine differences in effectiveness between primary healthcare area (PHA) and in-hospital specialized management protocols during six months of follow-up. METHOD: A multicenter, non-inferiority, randomized, controlled trial with two open parallel arms and a cost-effectiveness analysis was performed in six tertiary hospitals in Spain...
April 17, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29662915/patient-perspectives-of-midlevel-providers-in-orthopaedic-sports-medicine
#4
Blaine T Manning, Daniel D Bohl, Charles P Hannon, Michael L Redondo, David R Christian, Brian Forsythe, Shane J Nho, Bernard R Bach
Background: Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. Purpose: To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician...
April 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29660297/structured-integration-of-family-planning-curriculum-comparative-assessment-of-knowledge-and-skills-among-new-medical-graduates-in-ethiopia
#5
Berhanu G Gebremeskel, Alula M Teklu, Lia T Gebremedhin, Solomon W Beza, Tegbar Yigzaw, Munir K Eshetu, Mengistu H Damtew, Yolanda R Smith
OBJECTIVE: To assess if structured integration of a comprehensive family planning (FP) training into a medical school curriculum improves FP knowledge and skill scores of medical interns. STUDY DESIGN: We compared mean contraception knowledge scores of interns in a medical school with the integrated FP curriculum [intervention school] (n=56) to interns at four conventional medical curriculum schools without structured reinforcement of FP content [control schools] (n=161) in Ethiopia...
April 13, 2018: Contraception
https://www.readbyqxmd.com/read/29659856/integration-of-physical-abuse-clinical-decision-support-into-the-electronic-health-record-at-a-tertiary-care-children-s-hospital
#6
Srinivasan Suresh, Richard A Saladino, Janet Fromkin, Emily Heineman, Tom McGinn, Rudolph Richichi, Rachel P Berger
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set...
April 12, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#7
EDITORIAL
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
March 21, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29653439/medical-cannabis-an-oxymoron-physicians-perceptions-of-medical-cannabis
#8
Yuval Zolotov, Simon Vulfsons, Dana Zarhin, Sharon Sznitman
BACKGROUND: Medical cannabis policies are changing in many places around the world, and physicians play a major role in the implementation of these policies. The aim of this study was to gain a deeper understanding of physicians' views on medical cannabis and its possible integration into their clinic, as well as to identify potential underlying factors that influence these perceptions. METHODS: Qualitative narrative analysis of in-depth interviews with twenty-four Israeli physicians from three specialties (pain medicine, oncology and family medicine)...
April 10, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29653266/proteome-based-systems-biology-in-chronic-pain
#9
David Gomez-Varela, Allison M Barry, Manuela Schmidt
Chronic pain represents a major medical challenge in the 21st century. Enormous efforts have been invested towards deciphering the complexity of chronic pain from different angles (molecular, physiological, psychosocial, and behavioral) in both preclinical and clinical settings. While progress has been made, our understanding of the underlying mechanisms of chronic pain remains insufficient. Consequently, chronic pain treatment is often inadequate. It lacks efficacy in most patients and is associated with detrimental side effects - a situation which calls for urgent changes in pain research and management...
April 10, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29652747/the-incremental-clinical-value-of-cardiac-hybrid-spect-cta-imaging-in-coronary-artery-disease
#10
Lin Qiu, Hui Tan, Dengfeng Cheng, Hongcheng Shi
Coronary artery disease (CAD) is a major cause of death worldwide. It is significantly important to assess the coronary lesion and its pathophysiological relevance comprehensively. Coronary computed tomography angiography (CTA) or myocardial perfusion imaging alone suffers from some limitations in the evaluation of CAD. Through the integration and spatial colocalization of complementary morphological and functional information, the results of published hybrid single-photon emission computed tomography (SPECT)/CTA studies in patients with CAD are promising for detecting functionally relevant coronary artery lesion and evaluating the relationship between diseased coronary artery, coronary artery anomaly, myocardial bridging, or coronary calcification and myocardial ischemia...
April 12, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#11
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29650742/supporting-adults-with-intellectual-and-developmental-disabilities-to-participate-in-health-care-decision-making
#12
REVIEW
William F Sullivan, John Heng
OBJECTIVE: To discuss what is new in the revised guideline 3 of the "Primary care of adults with intellectual and developmental disabilities [IDD]. 2018 Canadian consensus guidelines" on decision-making capacity, and how to implement the recommendations. QUALITY OF EVIDENCE: Integrative review based on a literature search, the framework of the United Nations Convention on the Rights of Persons with Disabilities, and the experience of the authors. MAIN MESSAGE: Person-centred health care of adults with IDD should include all possible contributions from the patient in decision making...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29650740/managing-complexity-in-care-of-patients-with-intellectual-and-developmental-disabilities-natural-fit-for-the-family-physician-as-an-expert-generalist
#13
REVIEW
Elizabeth Grier, Dara Abells, Ian Casson, Meg Gemmill, Jessica Ladouceur, Amanda Lepp, Ullanda Niel, Samantha Sacks, Kyle Sue
OBJECTIVE: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter. SOURCES OF INFORMATION: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29650621/barriers-to-and-enablers-of-advance-care-planning-with-patients-in-primary-care-survey-of-health-care-providers
#14
Michelle Howard, Carrie Bernard, Doug Klein, Dawn Elston, Amy Tan, Marissa Slaven, Doris Barwich, John J You, Daren K Heyland
OBJECTIVE: To identify barriers to and enablers of advance care planning (ACP) perceived by physicians and other health professionals in primary care. DESIGN: Cross-sectional, self-administered survey. SETTING: Ontario, Alberta, and British Columbia. PARTICIPANTS: Family physicians (n = 117) and other health professionals (n = 64) in primary care. MAIN OUTCOME MEASURES: Perceived barriers relating to the clinician, characteristics of patients, and system factors, rated on a 7-point scale from 0 (not at all) to 6 (an extreme amount), and enablers reported using an open-ended question...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29650070/communication-and-ethics-in-the-clinical-examination
#15
REVIEW
Sharon Onguti, Sherine Mathew, Christine Todd
At the heart of every effective patient-physician interaction is a relationship that is built on trust. Cultivating sound communication skills coupled with the awareness and application of ethical principles is integral to this process. One of the foremost challenges in competent practice is negotiating situations that arise at the bedside when such issues as patient autonomy, differing world views, honesty, and cost stewardship come into conflict. It is essential for health care providers to consider how to detect and prioritize these issues as they advocate for high-quality and patient-centered care...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29649999/the-financial-transaction-between-counseling-and-nursing-care-service-centers-cncscs-and-their-clients-a-qualitative-study
#16
Sefollah Alaei, Fatemeh Alhani, Hassan Navipour
BACKGROUND: Community-oriented nursing care is an important model of nursing care. Counseling and Nursing Care Service Centers (CNCSCs) have been providing these private services to the Iranian community for nearly two decades. Resource management, cost-benefit analysis and affordability are important steps in providing these services. The present study was conducted to explore the challenges of financial transactions between CNCSCs and their clients. METHODS: This study has a qualitative design and was conducted on a total of 30 participants, consisting of CNCSC managers, staff, physicians and clients who were selected through purposive theoretical sampling...
April 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29649396/surgeons-perceived-barriers-to-palliative-and-end-of-life-care-a-mixed-methods-study-of-a-surgical-society
#17
Pasithorn A Suwanabol, Ari C Reichstein, Z Tuba Suzer-Gurtekin, Jane Forman, Maria J Silveira, Lona Mody, Arden M Morris
BACKGROUND: Nearly 20% of colorectal cancer (CRC) patients present with potentially incurable (Stage IV) disease, yet their physicians do not integrate cancer treatment with palliative care. Compared with patients treated by primary providers, surgical patients with terminal diseases are significantly less likely to receive palliative or end-of-life care. OBJECTIVE: To describe surgeon perspectives on palliative and end-of-life care for patients with Stage IV CRCs...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29628018/barriers-and-facilitators-affecting-the-implementation-of-substance-use-screening-in-primary-care-clinics-a-qualitative-study-of-patients-providers-and-staff
#18
Jennifer McNeely, Pritika C Kumar, Traci Rieckmann, Erica Sedlander, Sarah Farkas, Christine Chollak, Joseph L Kannry, Aida Vega, Eva A Waite, Lauren A Peccoralo, Richard N Rosenthal, Dennis McCarty, John Rotrosen
BACKGROUND: Alcohol and drug use are leading causes of morbidity and mortality that frequently go unidentified in medical settings. As part of a multi-phase study to implement electronic health record-integrated substance use screening in primary care clinics, we interviewed key clinical stakeholders to identify current substance use screening practices, barriers to screening, and recommendations for its implementation. METHODS: Focus groups and individual interviews were conducted with 67 stakeholders, including patients, primary care providers (faculty and resident physicians), nurses, and medical assistants, in two urban academic health systems...
April 9, 2018: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29627097/social-inclusion-through-para-sport-a-critical-reflection-on-the-current-state-of-play
#19
REVIEW
Jason Bantjes, Leslie Swartz
Medicine has played an integral role in both the inception and development of the Paralympic Games. Sports physicians are well positioned to continue to influence the development of the paralympic movement and to help focus the movement on its agenda to promote social inclusion. This article looks critically at some of the key challenges that the paralympic movement faces in its quest to promote social inclusion, and considers the role of sports medicine in this process.
May 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29626403/providers-and-patients-caught-between-standardization-and-individualization-individualized-standardization-as-a-solution-comment-on-re-making-the-procrustean-bed-standardization-and-customization-as-competing-logics-in-healthcare
#20
Lena Ansmann, Holger Pfaff
In their 2017 article, Mannion and Exworthy provide a thoughtful and theory-based analysis of two parallel trends in modern healthcare systems and their competing and conflicting logics: standardization and customization. This commentary further discusses the challenge of treatment decision-making in times of evidence-based medicine (EBM), shared decision-making and personalized medicine. From the perspective of systems theory, we propose the concept of individualized standardization as a solution to the problem...
August 12, 2017: International Journal of Health Policy and Management
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