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https://www.readbyqxmd.com/read/28333606/patterns-of-multiple-emergency-department-visits-do-primary-care-physicians-matter
#1
Daniel D Maeng, Jing Hao, John B Bulger
CONTEXT: Overutilization and overreliance on Emergency Departments (EDs) as a usual source of care can lead to unnecessarily high costs and undesirable consequences, such as a gap in care coordination and inadequate provision of preventive care. OBJECTIVE: To identify factors associated with multiple ED visits by patients, in particular, the impact of primary care physicians (PCPs) on their patients' multiple ED visit rates. DESIGN: Geisinger Health Plan claims data among adult patients who averaged more than 1 ED visit within a 12-month period between 2013 and 2014 were obtained (N = 20,351)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28327828/-tuberculosis-in-health-workers-in-peru-2013-2015
#2
Mirtha Gabriela Soto-Cabezas, Ana María Chávez-Pachas, Juan Carlos Arrasco-Alegre, Martin Javier Alfredo Yagui-Moscoso
Objectives.: To describe the characteristics of tuberculosis epidemiology in Peruvian health workers. Materials and methods.: A descriptive study was performed. It included all health workers with tuberculosis listed in the national epidemiological surveillance system of the Peruvian Ministry of Health, during 2013, 2014, and 2015. Results.: A total of 755 cases of tuberculosis in health workers were reported: 60% worked in hospitals, 28% worked in primary-care facilities, and 12% worked in private facilities...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28327157/factors-influencing-implementation-of-a-patient-decision-aid-in-a-developing-country-an-exploratory-study
#3
Wen Ting Tong, Yew Kong Lee, Chirk Jenn Ng, Ping Yein Lee
BACKGROUND: Most studies on barriers and facilitators to implementation of patient decision aids (PDAs) are conducted in the west; hence, the findings may not be transferable to developing countries. This study aims to use a locally developed insulin PDA as an exemplar to explore the barriers and facilitators to implementing PDAs in Malaysia, an upper middle-income country in Asia. METHODS: Qualitative methodology was adopted. Nine in-depth interviews (IDIs) and three focus group discussions (FGDs) were conducted with policymakers (n = 6), medical officers (n = 13), diabetes educators (n = 5) and a nurse, who were involved in insulin initiation management at an academic primary care clinic...
March 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28320586/patients-experience-in-the-early-recovery-phase-after-removal-of-intraoral-squamous-cell-carcinoma-with-carbon-dioxide-laser
#4
M Gilmartin, T Ali, S N Rogers
Laser excision of oral cancer is well established. The aim of this cross-sectional survey was to ask patients about their main symptoms and the severity of them during the first postoperative weeks. We devised a short questionnaire in collaboration with patients, and did a cross-sectional survey of 50 consecutive patients who had laser excision of T1 and T2 oral cancers over a two-year period. The response rate was 76% (38/50). Twenty patients reported that eating was "quite a bit" or "very much of a problem" and 13 reported similar for pain...
March 17, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28320359/chronic-cough-conundrum-a-case-report-of-a-new-diagnosis-of-hiv-and-pulmonary-kaposi-s-sarcoma
#5
Pamela P Bailey, Marylou M Dryer, John P Piper, Sajjad Ahmad
BACKGROUND: When evaluating a common complaint such as cough, clinicians should rely on a patient's history and physical to guide them, but also not diverge from guidelines in screening and testing lest certain diagnoses be overlooked. CASE PRESENTATION: A 44 year old Hispanic male presented to a pulmonologist's office after failing multiple courses of antibiotics for chronic cough, now six months in duration. He described intermittent scant hemoptysis and an evanescent migratory non-pruritic rash occasionally noted on his trunk or limbs...
March 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28319530/oral-chemical-burns-reported-to-the-poisons-information-centre-in-erfurt-germany-from-1997-to-2014
#6
Juliane Nehrlich, Hans-Peter Klöcking, Helmut Hentschel, Amelie Lupp
Devastating oral burns often followed by lifelong complications can result from ingestion of caustic substances. However, although being one of the most challenging situations in clinical practice, literature data on the epidemiology of oral burns are still scarce. Retrospective analysis of all cases of oral burns after ingestion of corrosive substances reported to the Poisons Information Centre in Erfurt, Germany, from 1997 to 2014 was performed. In total, 482 calls because of oral burns were registered, with no change in the numbers of cases during the years...
March 13, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28299300/the-health-seeking-behaviors-and-perceptions-of-iranian-patient-with-osteoarthritis-about-pain-management-a-qualitative-study
#7
Vahid Zamanzadeh, Fazlollah Ahmadi, Marjaneh Foolady, Mozhgan Behshid, Alireza Irajpoor
Introduction: Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians' offices...
March 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28292222/the-transition-to-the-adult-health-care-system-among-youths-with-autism-spectrum-disorder
#8
Robert A Nathenson, Benjamin Zablotsky
OBJECTIVE: The study examined how health care utilization patterns among youths with autism spectrum disorder (ASD) change as they transition into the adult health care system. METHODS: Data came from the Clinformatics Data Mart Database, a nationally diverse, clinically rich, private insurance claims database. The analytic sample consisted of youths ages 16 to 23 who were diagnosed as having ASD (N=16,338). Cross-sectional multivariate linear regressions determined whether service usage in home, office or outpatient, inpatient, and emergency department (ED) settings differed by age...
March 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28288358/life-cycle-ghg-evaluation-of-organic-rice-production-in-northern-thailand
#9
Sanwasan Yodkhum, Shabbir H Gheewala, Sate Sampattagul
Greenhouse gas (GHG) emission is one of the serious international environmental issues that can lead to severe damages such as climate change, sea level rise, emerging disease and many other impacts. Rice cultivation is associated with emissions of potent GHGs such as methane and nitrous oxide. Thai rice has been massively exported worldwide however the markets are becoming more competitive than ever since the green market has been hugely promoted. In order to maintain the same level or enhance of competitiveness, Thai rice needs to be considered for environmentally conscious products to meet the international environmental standards...
March 9, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28286406/the-gray-zone-of-police-work-during-mental-health-encounters-findings-from-an-observational-study-in-chicago
#10
Jennifer D Wood, Amy C Watson, Anjali J Fulambarker
Although improving police responses to mental health crises has received significant policy attention, most encounters between police and persons with mental illnesses do not involve major crimes or violence, nor do they rise to the level of requiring emergency apprehension. Here, we report on field observations of police officers handling mental health-related encounters in Chicago. Findings confirm that these encounters often occur in the "gray zone", where the problems at hand do not call for formal or legalistic interventions including arrest and emergency apprehension...
March 2017: Police Q
https://www.readbyqxmd.com/read/28282646/point-of-care-sexually-transmitted-infection-diagnostics-proceedings-of-the-star-sexually-transmitted-infection-clinical-trial-group-programmatic-meeting
#11
Anthony D Cristillo, Claire C Bristow, Rosanna Peeling, Barbara Van Der Pol, Sasha Herbst de Cortina, Ivan K Dimov, Nitika Pant Pai, Dong Jin Shin, Ricky Y T Chiu, Catherine Klapperich, Purnima Madhivanan, Sheldon R Morris, Jeffrey D Klausner
The goal of the point-of-care (POC) sexually transmitted infection (STI) Diagnostics meeting was to review the state-of-the-art research and develop recommendations for the use of POC STI diagnostics. Experts from academia, government, nonprofit, and industry discussed POC diagnostics for STIs such as Chlamydia trachomatis, human papillomavirus, Neisseria gonorrhoeae, Trichomonas vaginalis, and Treponema pallidum. Key objectives included a review of current and emerging technologies, clinical and public health benefits, POC STI diagnostics in developing countries, regulatory considerations, and future areas of development...
April 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28279584/simulation-training-for-the-office-based-anesthesia-team
#12
REVIEW
Richard M Ritt, Jeffrey Bennett, David Todd
An OMS office is a complex environment. Within such an environment, a diverse scope of complex surgical procedures is performed with different levels of anesthesia, ranging from local anesthesia to general anesthesia, on patients with varying comorbidities. Optimal patient outcomes require a functional surgical and anesthetic team, who are familiar with both standard operational principles and emergency recognition and management. Offices with high volume and time pressure add further stress and potential risk to the office environment...
March 6, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28274237/comparison-of-two-european-paediatric-emergency-departments-does-primary-care-organisation-influence-emergency-attendance
#13
F Poropat, P Heinz, E Barbi, A Ventura
BACKROUND: To compare paediatric Emergency Department (ED) attendances and admission outcomes in two European hospitals with different paediatric primary care set-up. METHODS: This is a retrospective prevalence study comparing all paediatric ED attendances during calendar years 2013 in two EDs with similar catchment area: one in Italy (Trieste) where paediatric primary care is provided by office paediatricians, the other, in the UK (Cambridge), where paediatric primary care is provided by general practitioners...
March 8, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28274125/training-generalist-doctors-for-rural-practice-in-new-zealand
#14
Garry Nixon, Katharina Blattner, Martyn Williamson, Patrick McHugh, James Reid
Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28267595/economic-burden-of-herpes-zoster-culebrilla-in-latin-america
#15
Emmanouil Rampakakis, Clare Pollock, Claudia Vujacich, Joao Toniolo Neto, Alejandro Ortiz Covarrubias, Homero Monsanto, Kelly D Johnson
BACKGROUND: Herpes zoster (HZ) is characterized by debilitating pain and blistering dermatomal rash. The most common complication of HZ is postherpetic neuralgia (PHN), a persistent pain that can substantially affects patients' quality of life. HZ has significant impact on patients' lives with considerable implications for healthcare systems and society. The purpose of this study was to evaluate the healthcare resource utilization (HCRU) and medical costs associated with HZ in Latin America...
March 3, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28265317/inguinoscrotal-pathology
#16
REVIEW
Luis Guerra, Michael Leonard
Infants, children, and adolescents with inguinoscrotal pathology comprise a significant proportion of emergency department and outpatient visits. Visits to the emergency department primarily comprise individuals presenting with scrotal pain due to testicular torsion or torsion of the testicular appendages. At such time, immediate urological consultation is sought. Outpatient visits comprise those individuals with undescended testes, hydroceles, and varicoceles. Rare, but important problems, such as pediatric testicular tumours, may also present in the office setting...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28264950/direct-to-consumer-telehealth-may-increase-access-to-care-but-does-not-decrease-spending
#17
J Scott Ashwood, Ateev Mehrotra, David Cowling, Lori Uscher-Pines
The use of direct-to-consumer telehealth, in which a patient has access to a physician via telephone or videoconferencing, is growing rapidly. A key attraction of this type of telehealth for health plans and employers is the potential savings involved in replacing physician office and emergency department visits with less expensive virtual visits. However, increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending. We used commercial claims data on over 300,000 patients from three years (2011-13) to explore patterns of utilization and spending for acute respiratory illnesses...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28260435/role-of-more-active-identification-of-brain-dead-cases-in-increasing-organ-donation
#18
Farahnaz Sadegh Beigee, Mojtaba Mohsenzadeh, Shagin Shahryari, Meysam Mojtabaee
OBJECTIVES: Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. MATERIALS AND METHODS: From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28257612/health-care-in-high-school-athletics-in-west-virginia
#19
Kyle Schneider, Wesley Meeteer, Jill A Nolan, H David Campbell
INTRODUCTION: The purpose of this study was to determine the level of implementation of emergency preparedness procedures and administrative procedures to provide appropriate medical coverage to high school athletics in the predominantly rural US state of West Virginia. Particular attention was given to determine the extent to which the schools provided the recommendations for best practice in the National Athletic Trainers Association consensus statement outlining appropriate medical coverage for high school athletics...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28256999/characteristics-of-primary-care-physicians-in-patient-centered-medical-home-practices-united-states-2013
#20
Esther Hing, Ellen Kurtzman, Denys T Lau, Caroline Taplin, Andrew B Bindman
Objective-This report describes the characteristics of primary care physicians in patient-centered medical home (PCMH) practices and compares these characteristics with those of primary care physicians in non-PCMH practices. Methods-The data presented in this report were collected during the induction interview for the 2013 National Ambulatory Medical Care Survey, a national probability sample survey of nonfederal physicians who see patients in office settings in the United States. Analyses exclude anesthesiologists, radiologists, pathologists, and physicians in community health centers...
February 2017: National Health Statistics Reports
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