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https://www.readbyqxmd.com/read/28228138/current-management-practices-for-patients-presenting-with-low-back-pain-to-a-large-emergency-department-in-canada
#1
Matthew L Nunn, Jill A Hayden, Kirk Magee
BACKGROUND: Low back pain (LBP) is one of the leading causes of disability. Presentations to the emergency department (ED) are common and consume significant healthcare resources. However, treatment of patients with LBP is variable and highly physician dependent. Our study objective was to describe the demographic and clinical characteristics of patients presenting to the ED with LBP, the diagnostic strategies employed by ED physicians, and the subsequent management. METHODS: We conducted a retrospective study using clinical and electronic health data at the Queen Elizabeth II Health Science Center's Charles V...
February 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28225805/prevalence-and-risk-factors-of-chlamydia-infection-in-hong-kong-a-population-based-geospatial-household-survey-and-testing
#2
William Chi Wai Wong, Yanping Zhao, Ngai Sze Wong, William L Parish, Heidi Yin Hai Miu, Li-Gang Yang, Michael Emch, King Man Ho, Francois Yeung Fong, Joseph D Tucker
BACKGROUND: Chlamydia causes infertility and increases risk of HIV infection, and population-based studies provide essential information for effective infection control and prevention. This study examined Chlamydia trachomatis prevalence and risk factors among a representative sample of 18-49-year-old residents in Hong Kong. METHODS: Census boundary map of 412 constituency areas was used as primary sampling units to construct the sampling frame and, residential buildings and units were randomly selected using geospatial modelling...
2017: PloS One
https://www.readbyqxmd.com/read/28223112/understanding-and-applying-the-concept-of-value-creation-in-radiology
#3
David B Larson, Daniel J Durand, Daniel S Siegal
The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care...
February 17, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28222904/the-2016-proposal-for-the-reorganisation-of-urgent-care-provision-in-belgium-a-political-struggle-to-co-locate-primary-care-providers-and-emergency-departments
#4
Koen Van den Heede, Wilm Quentin, Cécile Dubois, Stephan Devriese, Carine Van de Voorde
Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs...
February 17, 2017: Health Policy
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#5
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28215356/the-financial-burden-of-prescription-drugs-for-neurological-conditions-in-canada-results-from-the-national-population-health-study-of-neurological-conditions
#6
Sara Guilcher, Sarah Munce, James Conklin, Tanya Packer, Molly Verrier, Connie Marras, Tarik Bereket, Joan Versnel, Richard Riopelle, Susan Jaglal
This paper describes the current situation in Canada concerning the availability and use of prescription drugs for neurological conditions. We conducted semi-structured qualitative interviews with health care providers, administrators, community organization representatives, opinion leaders and policy makers. The analysis revealed three primary themes related to the availability of and access to prescription drugs to treat neurological conditions. First, we learned that across Canada there is significant vulnerability and a need for advocacy on behalf of people living with these conditions...
February 4, 2017: Health Policy
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#7
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28211045/walk-in-clinics-versus-physician-offices-and-emergency-rooms-for-urgent-care-and-chronic-disease-management
#8
REVIEW
Connie E Chen, Christopher T Chen, Jia Hu, Ateev Mehrotra
BACKGROUND: Walk-in clinics are growing in popularity around the world as a substitute for traditional medical care delivered in physician offices and emergency rooms, but their clinical efficacy is unclear. OBJECTIVES: To assess the quality of care and patient satisfaction of walk-in clinics compared to that of traditional physician offices and emergency rooms for people who present with basic medical complaints for either acute or chronic issues. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers on 22 March 2016 together with reference checking, citation searching, and contact with study authors to identify additional studies...
February 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28199918/factors-associated-with-alcohol-use-prior-to-and-during-pregnancy-among-hiv-infected-pregnant-women-in-cape-town-south-africa
#9
Kirsty Brittain, Robert H Remien, Tamsin Phillips, Allison Zerbe, Elaine J Abrams, Landon Myer, Claude A Mellins
INTRODUCTION: Alcohol use during pregnancy is prevalent in South Africa, but there are few prospectively-collected data exploring patterns of consumption among HIV-infected women, which may be important to improve maternal and child health outcomes. We examined patterns of and factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa. METHODS: Participants were enrolled when entering antenatal care at a large primary care clinic, and alcohol use was assessed using the AUDIT (Alcohol Use Disorders Identification Test)...
January 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28173782/healthesteps%C3%A2-study-protocol-a-pragmatic-randomized-controlled-trial-promoting-active-living-and-healthy-lifestyles-in-at-risk-canadian-adults-delivered-in-primary-care-and-community-based-clinics
#10
Dawn P Gill, Wendy Blunt, Cassandra Bartol, Roseanne W Pulford, Ashleigh De Cruz, P Karen Simmavong, Adam Gavarkovs, Ian Newhouse, Erin Pearson, Bayley Ostenfeldt, Barbi Law, Kristina Karvinen, Pertice Moffit, Gareth Jones, Cori Watson, Guangyong Zou, Robert J Petrella
BACKGROUND: Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits...
February 7, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28173740/emergency-department-redirection-to-primary-care-a-prospective-evaluation-of-practice
#11
James A Bentley, Shobhan Thakore, William Morrison, Weijie Wang
Background and aim Non-urgent Emergency Department presentations contribute to overcrowding, which can adversely affect patient care. Redirecting patients to a more appropriate service is an option to help address this. We conducted a prospective evaluation of a major Scottish hospital's Emergency Department redirection policy to assess its safety. Methods and results Over two months, 620 patients triggered senior assessment for redirection with 444 (72%) redirected to primary care. Information on presentation was collected with subsequent management and outcome of redirection provided by the patient's general practitioner...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28170371/imaging-tests-in-staging-and-surveillance-of-non-metastatic-breast-cancer-changes-in-routine-clinical-practice-and-cost-implications
#12
S De Placido, C De Angelis, M Giuliano, C Pizzi, R Ruocco, V Perrone, D Bruzzese, G Tommasielli, M De Laurentiis, S Cammarota, G Arpino, G Arpino
BACKGROUND: Although guidelines do not recommend computerised tomography (CT), positron emission tomography (PET) or magnetic resonance imaging (MRI) for the staging or follow-up of asymptomatic patients with non-metastatic breast cancer, they are often requested in routine clinical practice. The aim of this study was to determine the staging and follow-up patterns, and relative costs in a large population of breast cancer patients living and treated in a Southern Italian region. METHODS: We analysed the clinical computerised information recorded by 567 primary-care physicians assisting about 650 000 inhabitants in the Campania region...
February 7, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#13
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28167749/evaluation-of-demands-usage-and-unmet-needs-for-emergency-care-in-yaound%C3%A3-cameroon-a-cross-sectional-study
#14
Young Sun Ro, Sang Do Shin, Joongsik Jeong, Min Jung Kim, Young Hee Jung, Joseph Kamgno, Etoundi Mballa Georges Alain, Bonaventure Hollong
OBJECTIVES: To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers. DESIGN: A cross-sectional study using a community-based survey. SETTING: Yaoundé, Cameroon. PARTICIPANTS: All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé...
February 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28159557/rates-of-hip-and-knee-joint-replacement-amongst-different-ethnic-groups-in-england-an-analysis-of-national-joint-registry-data
#15
Michèle C Smith, Yoav Ben-Shlomo, Paul Dieppe, Andrew D Beswick, J Mark Wilkinson, Ashley W Blom
OBJECTIVE: Despite a health care system that is free at the point of delivery, ethnic minorities may not always get care equitable to that of White patients in England. We examined whether ethnic differences exist in joint replacement rates and surgical practice in England. DESIGN: 373,613 hip and 428,936 knee National Joint Registry primary replacement patients had coded ethnicity in Hospital Episode Statistics. Age and gender adjusted observed/expected ratios of hip and knee replacements amongst ethnic groups were compared using indirect standardisation...
January 31, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28158876/predictors-of-the-need-for-therapeutic-intervention-in-older-adult-patients-with-a-nonvariceal-gastrointestinal-bleed
#16
Khalid Abusaada, Xiaoping He, Fnu Asad-Ur-Rahman, Umair Majeed, Evgeny Idrisov, Sameen Khalid, Xiang Zhu, Vladimir Pech, George Everett
OBJECTIVE: Gastrointestinal bleeding (GIB) is a common cause of hospitalization in the older adult population. The aim of the study was to identify factors that are associated with the need for a therapeutic intervention in patients older than 65 years with nonvariceal GIB. METHODS: This is a retrospective cohort study of older adult patients admitted to a tertiary care center between 2009 and 2011 with nonvariceal GIB. The primary outcome was a composite endpoint of inpatient mortality or need for an endoscopic, surgical, or radiologic procedure to control the bleed or to treat the underlying source of the bleed...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28152927/reducing-wait-time-wt-in-the-infusion-center-ic
#17
Lianne Lopez, Angela Aschian, Betty Chan, Martha Inofuentes, Zoraida Truax, Sally Golingay, Gwendoyn Lynch, Peggy Matsuura, Afsaneh Barzi
: 249 Background: Lengthy WT is the primary source of dis-satisfaction with IC services. We created a patient (PT) flow diagram outlining each step beginning from PT check-in to discharge and plotted the impact of multiple disciplines on the WT. A team of nurses, pharmacists, physicians, and administrators, analyzed the flow and identified ways to improve efficiencies. METHODS: First attempt was to improve communications between pharmacy and nursing, coordinating the preparation of medications with patient's check-in time; use of a simple clipboard facilitated this task and improved the efficiency of the system...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28139511/evaluation-of-outpatient-antibiotic-use-in-beijing-general-hospitals-in-2015
#18
Chuan Yang, Wen-Qiang Cai, Zi-Jun Zhou
BACKGROUND: Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015. METHODS: We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28122533/offering-general-pediatric-care-during-the-hard-times-of-the-2014-ebola-outbreak-looking-back-at-how-many-came-and-how-well-they-fared-at-a-m%C3%A3-decins-sans-fronti%C3%A3-res-referral-hospital-in-rural-sierra-leone
#19
Veerle Hermans, Rony Zachariah, Desalegn Woldeyohannes, Gbessay Saffa, Dauda Kamara, Nimer Ortuno-Gutierrez, Walter Kizito, Marcel Manzi, Petra Alders, Jacob Maikere
BACKGROUND: In Bo district, rural Sierra Leone, we assessed the burden of the 2014 Ebola outbreak on under-five consultations at a primary health center and the quality of care for under-15 children at a Médecins Sans Frontières (MSF) referral hospital. METHODS: Retrospective cohort study, comparing a period before (May-October 2013) and during the same period of the Ebola outbreak (2014). Health worker infections occurred at the outbreak peak (October 2014), resulting in hospital closure due to fear of occupational-risk of contracting Ebola...
January 25, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28122500/costs-of-care-at-the-end-of-life-among-elderly-patients-with-chronic-kidney-disease-patterns-and-predictors-in-a-nationwide-cohort-study
#20
Bradley Chen, Victoria Y Fan, Yiing-Jenq Chou, Chin-Chi Kuo
BACKGROUND: Despite the urgent need for evidence to guide the end-of-life (EOL) care for patients with chronic kidney disease (CKD), we have limited knowledge of the costs and intensity of EOL care in this population. The present study examined patterns and predictors for EOL care intensity among elderly patients with CKD. METHODS: We conducted a retrospective nationwide cohort study utilizing the Taiwan National Health Insurance (NHI) Research Database. A total of 65,124 CKD patients aged ≥ 60 years, who died in hospitals or shortly after discharge between 2002 and 2012 were analyzed...
January 26, 2017: BMC Nephrology
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