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https://www.readbyqxmd.com/read/28102909/the-effects-of-hospital-characteristics-on-delays-in-breast-cancer-diagnosis-in-appalachian-communities-a-population-based-study
#1
Christopher J Louis, Jonathan R Clark, Marianne M Hillemeier, Fabian Camacho, Nengliang Yao, Roger T Anderson
PURPOSE: Despite being generally accepted that delays in diagnosing breast cancer are of prognostic and psychological concern, the influence of hospital characteristics on such delays remains poorly understood, especially in rural and underserved areas. However, hospital characteristics have been tied to greater efficiency and warrant further investigation as they may have implications for breast cancer care in these areas. METHODS: Study data were derived from the Kentucky, North Carolina, Ohio, and Pennsylvania state central cancer registries (2006-2008)...
January 19, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28102791/an-exemplar-of-naturalistic-inquiry-in-general-practice-research
#2
Susan McInnes, Kath Peters, Andrew Bonney, Elizabeth Halcomb
Background Before beginning any research project, novice researchers must consider which methodological approach will best address their research questions. The paucity of literature describing a practical application of naturalistic inquiry adds to the difficulty they may experience. Aim To provide a practical example of how naturalistic inquiry was applied to a qualitative study exploring collaboration between registered nurses and general practitioners working in Australian general practice. Discussion Naturalistic inquiry is not without its critics and limitations...
January 23, 2017: Nurse Researcher
https://www.readbyqxmd.com/read/28102774/interactions-between-c-reactive-protein-and-traditional-risk-factors-in-predicting-mortality-of-older-adults
#3
Henrik Rudolf, Naemi Wall, Renate Klaassen-Mielke, Ulrich Thiem, Curt Diehm, Hans-Joachim Trampisch, Dietmar Krause
BACKGROUND: Elevated levels of C-reactive protein (CRP) are known to be associated with cardiovascular (CV) morbidity and mortality in older adults, however, there seems to be heterogeneity of this association across subsets of individuals. We aim to assess the effects of interactions between CRP and one of the following traditional CV risk factors regarding all-cause mortality in unselected elderly men and women: age, sex, body mass index, diabetes, and hypertension. PATIENTS AND METHODS: Three hundred and forty-four general practitioners all over Germany enrolled 6,817 unselected participants, aged 65 years or older, and performed thorough examinations, including CRP measurement at baseline (getABI study)...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102100/a-systematic-review-the-influence-of-real-time-feedback-on-wheelchair-propulsion-biomechanics
#4
Andrew Symonds, Giulia Barbareschi, Stephen Taylor, Catherine Holloway
BACKGROUND: Clinical guidelines recommend that, in order to minimize upper limb injury risk, wheelchair users adopt a semi-circular pattern with a slow cadence and a large push arc. OBJECTIVES: To examine whether real time feedback can be used to influence manual wheelchair propulsion biomechanics. REVIEW METHODS: Clinical trials and case series comparing the use of real time feedback against no feedback were included. A general review was performed and methodological quality assessed by two independent practitioners using the Downs and Black checklist...
January 19, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28101824/empirically-derived-weights-for-gms-capitation-payments-to-general-practitioners
#5
B McElroy
AIM: Unlike other weighted capitation schemes used in Irish health service financing and in health systems internationally, the GMS capitation payments scheme for General Practitioners lacks transparency in both the data used and the model employed. In this study, evidence-based weights were generated and compared to current payment weights. METHODS: Four datasets on GP utilisation were interrogated. RESULTS: Evidence-based weights indicated that over 70s had higher payments per consultation than other groups...
January 18, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#6
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100432/effectiveness-and-impact-of-a-reduced-infant-schedule-of-4cmenb-vaccine-against-group-b-meningococcal-disease-in-england-a-national-observational-cohort-study
#7
Sydel R Parikh, Nick J Andrews, Kazim Beebeejaun, Helen Campbell, Sonia Ribeiro, Charlotte Ward, Joanne M White, Ray Borrow, Mary E Ramsay, Shamez N Ladhani
BACKGROUND: In September, 2015, the UK became the first country to introduce the multicomponent group B meningococcal (MenB) vaccine (4CMenB, Bexsero) into a publicly funded national immunisation programme. A reduced two-dose priming schedule was offered to infants at 2 months and 4 months, alongside an opportunistic catch-up for 3 month and 4 month olds. 4CMenB was predicted to protect against 73-88% of MenB strains. We aimed to assess the effectiveness and impact of 4CMenB in vaccine-eligible infants in England...
December 3, 2016: Lancet
https://www.readbyqxmd.com/read/28100247/the-evolution-of-the-medical-workforce-in-cape-verde-since-independence-in-1975
#8
A P Delgado, A C Tolentino, P Ferrinho
BACKGROUND: Cape Verdean doctors have always graduated abroad. The first experience of pre-graduate medical education in Cape Verde begun in October 2015. Counting how many doctors Cape Verde has, knowing who they are, and knowing how they are distributed are very important to help fine-tune the medical training. The aim of this study is to analyze the evolution of the medical workforce in Cape Verde to support medical education implementation. METHODS: Secondary data on doctors, from July 1975 until December 2014, collected from the Ministry of Health, were entered into an SPSS 20 database and studied by a simple descriptive statistical analysis...
January 18, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28100232/equitable-health-services-for-the-young-a-decomposition-of-income-related-inequalities-in-young-adults-utilization-of-health-care-in-northern-sweden
#9
Paola A Mosquera, Anna-Karin Waenerlund, Isabel Goicolea, Per E Gustafsson
BACKGROUND: Despite the goal of the Swedish health system to offer health care according to the principle of horizontal equity, little is known about the equality in access to health care use among young people. To explore this issue, the present study aimed i) to assess horizontal inequity in health care utilization among young people in Northern Sweden; and ii) to explore the contribution of different factors to explain the observed inequalities. METHODS: Participants (N = 3016 youths aged 16-25 years) came from the "Health on Equal terms" survey conducted in 2014 in the four northernmost counties in Sweden...
January 18, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28100186/influenza-epidemic-surveillance-and-prediction-based-on-electronic-health-record-data-from-an-out-of-hours-general-practitioner-cooperative-model-development-and-validation-on-2003-2015-data
#10
Barbara Michiels, Van Kinh Nguyen, Samuel Coenen, Philippe Ryckebosch, Nathalie Bossuyt, Niel Hens
BACKGROUND: Annual influenza epidemics significantly burden health care. Anticipating them allows for timely preparation. The Scientific Institute of Public Health in Belgium (WIV-ISP) monitors the incidence of influenza and influenza-like illnesses (ILIs) and reports on a weekly basis. General practitioners working in out-of-hour cooperatives (OOH GPCs) register diagnoses of ILIs in an instantly accessible electronic health record (EHR) system. This article has two objectives: to explore the possibility of modelling seasonal influenza epidemics using EHR ILI data from the OOH GPC Deurne-Borgerhout, Belgium, and to attempt to develop a model accurately predicting new epidemics to complement the national influenza surveillance by WIV-ISP...
January 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#11
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28099985/-prospective-evaluation-of-the-quality-of-the-results-of-thyroid-surgery-in-an-ent-department
#12
Peter Rolf Issing, Hendrik Tebben, Martin Wenger, Torsten Köhler
Although the thyroid gland is located in the neck it is not a matter of fact that it is a clinical issue for the otorhinolaryngologist in Germany. Probably due to historic reasons general surgeons usually perform operations on the thyroid. As at our department this kind of treatment is an established procedure we prospectively evaluated our thyroid cases in order to present our results.The prospective study started in the year of 2014. So far 231 patients were enrolled with an average age of 53,5 years (16-89)...
January 18, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28099594/diagnosis-and-underdiagnosis-of-comorbidities-in-psoriasis-patients-need-for-a-multidisciplinary-approach
#13
Gleison Vieira Duarte, Maria de Fátima S P de Oliveira, Ivonise Follador, Thadeu Santo Silva, Edgar Marcelino de Carvalho
BACKGROUND: Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations. OBJECTIVE: To identify the prevalence of these comorbidities in 296 patients followed up at a university dermatology clinic...
November 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28098492/insomnia-management-in-the-australian-primary-care-setting
#14
Fatema-Tun-Naher Sake, Keith Wong, Delwyn J Bartlett, Bandana Saini
BACKGROUND AND OBJECTIVE: Insomnia is one of the most prevalent and costly sleep disorders presenting in general practice, and when left untreated, has major health consequences. However, studies are limited on how general practitioners respond to this health issue, especially since the reconceptualization of insomnia in DSM 5. Therefore, the aim of this study was to explore how insomnia is diagnosed and treated in Australian general practices. PARTICIPANTS: Twenty-four (54% male) general practitioners were recruited throughout the greater Sydney metropolitan area in New South Wales using the professional network of research team members and snowballing technique...
January 18, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28097406/the-uk-experience-of-promoting-dementia-recognition-and-management-in-primary-care
#15
Steve Iliffe, Jane Wilcock
BACKGROUND: The early and timely recognition of dementia syndrome is a policy imperative in many countries. In the UK the achievement of earlier and timelier recognition has been pursued through educational interventions, incentivisation of general practitioners and the promotion of a network of memory clinics. OBJECTIVE: The effectiveness of education, incentivisation and memory clinic activity are unknown. This article analyses data from different sources to evaluate the impact of these interventions on the incidence and prevalence of dementia, and the diagnostic performance of memory clinics...
January 17, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28095850/building-system-capacity-for-the-integration-of-mental-health-at-the-level-of-primary-care-in-tunisia-a-study-protocol-in-global-mental-health
#16
Jessica Spagnolo, François Champagne, Nicole Leduc, Myra Piat, Wahid Melki, Fatma Charfi, Marc Laporta
BACKGROUND: In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28095846/associations-between-degrees-of-task-delegation-and-job-satisfaction-of-general-practitioners-and-their-staff-a-cross-sectional-study
#17
Helle Riisgaard, Jens Søndergaard, Maria Munch, Jette V Le, Loni Ledderer, Line B Pedersen, Jørgen Nexøe
BACKGROUND: In recent years, the healthcare system in the western world has undergone a structural development caused by changes in demography and pattern of disease. In order to maintain the healthcare system cost-effective, new tasks are placed in general practice urging the general practitioners to rethink the working structure without compromising the quality of care. However, there is a substantial variation in the degree to which general practitioners delegate tasks to their staff, and it is not known how these various degrees of task delegation influence the job satisfaction of general practitioners and their staff...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28095818/when-parents-won-t-vaccinate-their-children-a-qualitative-investigation-of-australian-primary-care-providers-experiences
#18
Nina J Berry, Alexandra Henry, Margie Danchin, Lyndal J Trevena, Harold W Willaby, Julie Leask
BACKGROUND: Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. METHODS: Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28095624/-it-s-good-enough-swedish-general-dental-practitioners-on-reasons-for-accepting-sub-standard-root-filling-quality
#19
L Dahlström, O Lindwall, H Rystedt, C Reit
AIM: The concept of "good enough" is central and necessary in the assessment of root filling quality. The aim was to explore the concept by analysing reasons and arguments for the acceptance or rejection of substandard root filling quality as reported by GDPs in Sweden. METHODOLOGY: The study was designed as a qualitative and exploratory study based on seven videotaped focus group interviews analysed by means of qualitative content analysis. Thirty-three general dental practitioners (GDPs) employed in the Public Dental Health Service in Gothenburg, Sweden, participated (4-6 GDPs/interview)...
January 17, 2017: International Endodontic Journal
https://www.readbyqxmd.com/read/28095284/family-carers-perspectives-on-integrated-community-care-in-the-czech-republic
#20
Eva Křížová, Hana Janečková, Jaromír Běláček
AIM: The problem of family care for people dependent on another person has only recently become a focus of research. As demand for health and social services has not been adequately met by public service providers, growing attention has been given to informal care and the integration of families within systems of health and social care at the community level. This paper presents the results of a survey on informal carers' views and opinions under the current conditions of social support in the Czech Republic...
December 2016: Central European Journal of Public Health
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