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https://www.readbyqxmd.com/read/28334970/expenditure-tracking-and-review-of-reproductive-maternal-newborn-and-child-health-policy-in-pakistan
#1
Muhammad Ashar Malik, Abdul Sattar Nahyoun, Arjumand Rizvi, Zaid Ahmad Bhatti, Zulfiqar Ahmad Bhutta
Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals (MDGs) 4 and 5 were not achieved (2000-15). Maternal Mortality Ratio was reduced to 170 per 100 000 live births (target 100) by 2013 at an annual reduction rate of 3.6% (1990-2013). Against the target of 46 per 1000 live births, the Under Five Mortality Rate was reduced to 81 per 1000 live births by 2015 at an annual reduction rate of 2...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28333179/obtaining-antibiotics-online-from-within-the-uk-a-cross-sectional-study
#2
Sara Elizabeth Boyd, Luke Stephen Prockter Moore, Mark Gilchrist, Ceire Costelloe, Enrique Castro-Sánchez, Bryony Dean Franklin, Alison Helen Holmes
Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online. Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues...
February 17, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#3
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#4
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28327100/impact-of-a-continuing-medical-education-meeting-on-the-use-and-timing-of-urgent-cancer-referrals-among-general-practitioners-a-before-after-study
#5
Berit Skjødeberg Toftegaard, Flemming Bro, Alina Zalounina Falborg, Peter Vedsted
BACKGROUND: Detection of cancer in general practice is challenging because symptoms are diverse. Even so-called alarm symptoms have low positive predictive values of cancer. Nevertheless, appropriate referral is crucial. As 85% of cancer patients initiate their cancer diagnostic pathway in general practice, a Continuing Medical Education meeting (CME-M) in early cancer diagnosis was launched in Denmark in 2012. We aimed to investigate the effect of the CME-M on the primary care interval, patient contacts with general practice and use of urgent cancer referrals...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28319159/drug-therapy-for-alcohol-dependence-in-primary-care-in-the-uk-a-clinical-practice-research-datalink-study
#6
Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P van Staa, Munir Pirmohamed
AIM: To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care. DESIGN: Open cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Database. PARTICIPANTS: 39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013. MAIN OUTCOME MEASURE: Use of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence...
2017: PloS One
https://www.readbyqxmd.com/read/28306215/primary-mediastinal-and-retroperitoneal-malignant-germ-cell-tumors-in-children-and-adolescents-results-of-the-tgm95-trial-a-study-of-the-french-society-of-pediatric-oncology-soci%C3%A3-t%C3%A3-fran%C3%A3-aise-des-cancers-de-l-enfant
#7
Hélène Sudour-Bonnange, Cécile Faure-Conter, Hélène Martelli, Frederic Hameury, Brice Fresneau, Daniel Orbach, Cécile Vérité
PURPOSE: To examine the clinical presentation, treatment and results in children and adolescents with primary mediastinal (PM) and retroperitoneal (RP) germ cell tumors (GCTs). METHODS: The TGM95 trial for malignant GCTs was conducted in France between 1995 and 2005 to evaluate a strategy adapted to prognostic factors with cisplatin-based chemotherapy and surgical management. We reviewed patients with TGCTs at PM and RP sites. RESULTS: Among 239 patients, there were 16 patients with PM and 5 with RP tumors, which represent 9% of all patients, highlighting the rarity of these extragonadal locations...
March 17, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28301451/traumatic-brain-injury-related-emergency-department-visits-hospitalizations-and-deaths-united-states-2007-and-2013
#8
Christopher A Taylor, Jeneita M Bell, Matthew J Breiding, Likang Xu
PROBLEM/CONDITION: Traumatic brain injury (TBI) has short- and long-term adverse clinical outcomes, including death and disability. TBI can be caused by a number of principal mechanisms, including motor-vehicle crashes, falls, and assaults. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. REPORTING PERIOD: 2007 and 2013. DESCRIPTION OF SYSTEM: State-based administrative health care data were used to calculate estimates of TBI-related ED visits and hospitalizations by principal mechanism of injury, age group, sex, and injury intent...
March 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28296227/health-literacy-in-the-urgent-care-setting-what-factors-impact-consumer-comprehension-of-health-information
#9
Traci L Alberti, Nancy J Morris
BACKGROUND: An increasing number of Americans are using urgent care (UC) clinics due to: improved health insurance coverage, the need to decrease cost, primary care offices with limited appointment availability, and a desire for convenient care. Patients are treated by providers they may not know for episodic illness or injuries while in pain or not feeling well. Treatment instructions and follow-up directions are provided quickly. PURPOSE: To examine health literacy in the adult UC population and identify patient characteristics associated with health literacy risk...
March 10, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28294880/-results-of-monitoring-of-the-plan-of-measures-directed-to-reduction-of-ischemic-heart-disease-in-north-caucasus-republics-analysis-of-dynamics-of-cardio-vascular-mortality
#10
M N Mamedov
Comparative analysis of dynamics of cardiovascular mortality in Russia and foreign countries as well as main directions of development of cardiological service in Russia are presented in this review article. Plan of measures for reduction of mortality from ischemic heart disease (IHD) was created in 2015. This plan comprises 4 blocks of assessment of the following measures: directed at improvement of primary IHD prevention (1), directed at secondary prevention of complications of IHD (2); directed at improvement of efficacy of medical care of patients with IHD (3), and directed at monitoring of some demographic parameters (4)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28291697/early-prehospital-assessment-of-non-urgent-patients-and-outcomes-at-the-appropriate-level-of-care-a-prospective-exploratory-study
#11
Glenn Larsson, Anders Holmén, Kristina Ziegert
INTRODUCTION: The Ambulance Organization of Sweden provides qualified medical assessment and treatment by ambulance nurses based on patient needs regarding appropriate levels of care. A new model for patients with non-urgent medical conditions has been introduced. The main objective of this study was to examine early prehospital assessment of non-urgent patients, and its impact on the choice of the appropriate level of care. METHODS: The study design was a 1-year, prospective study, involving an ambulance district in southwestern Sweden with a population of 78,000...
March 10, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28276136/initial-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-in-australia-views-from-the-coal-face
#12
Bonnie Bereznicki, Haydn Walters, Julia Walters, Gregory Peterson, Luke Bereznicki
BACKGROUND: Early diagnosis and management can mitigate the long-term morbidity and mortality of chronic obstructive pulmonary disease (COPD). AIM: To gain insights into the initial diagnostic process and early management of COPD by Australian general practitioners (GPs). METHODS: A random sample of Australian GPs was invited to complete a postal survey, which assessed familiarity with and use of contemporary practice guidelines, diagnostic criteria, and management preferences for COPD...
March 9, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28275579/factors-influencing-surveillance-for-hepatocellular-carcinoma-in-patients-with-liver-cirrhosis
#13
Hager A Ahmed Mohammed, Ju Dong Yang, Nasra H Giama, Jonggi Choi, Hawa M Ali, Kristin C Mara, William S Harmsen, Russell H Wiesner, Michael D Leise, Terry M Therneau, Lewis R Roberts
OBJECTIVE: Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality worldwide, and a rising cause of cancer mortality in the U.S. Liver cirrhosis is the major risk factor for HCC. Surveillance of persons with cirrhosis facilitates early detection and improves outcomes. We assessed the surveillance rate for HCC within a major academic health system and identified factors influencing surveillance. PATIENTS AND METHODS: We examined the surveillance rate for HCC using liver ultrasound, CT, or MRI, and factors influencing surveillance in a cohort of 369 Minnesota residents with cirrhosis seen at the Mayo Clinic between 2007 and 2009...
February 2017: Liver Cancer
https://www.readbyqxmd.com/read/28256381/breaking-the-barriers-migrants-and-tuberculosis
#14
Giovanni Sotgiu, Masoud Dara, Rosella Centis, Alberto Matteelli, Ivan Solovic, Christina Gratziou, Adrian Rendon, Giovanni Battista Migliori
Tuberculosis (TB) can represent an important clinical and public health in developing and developed countries. Low- and middle-income countries are facing an epidemic which is difficult to address because of the drug-resistance spread and the association of TB with HIV/AIDS. High-income countries, whose TB incidence has decreased in the last decades, can be involved in new TB epidemic waves owing to social, healthcare, and economic hurdles and challenges. In particular, migrants coming from high TB incidence countries can represent a new epidemiological issue in the TB care and control in geographical areas where primary care and specialized centres are not equipped to face the clinical and public health issues associated with the TB disease...
February 27, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28255097/patient-and-provider-perspectives-on-the-design-and-implementation-of-an-electronic-consultation-system-for-kidney-care-delivery-in-canada-a-focus-group-study
#15
Aminu K Bello, Anita E Molzahn, Louis P Girard, Mohamed A Osman, Ikechi G Okpechi, Jodi Glassford, Stephanie Thompson, Erin Keely, Clare Liddy, Braden Manns, Kailash Jinda, Scott Klarenbach, Brenda Hemmelgarn, Marcello Tonelli
OBJECTIVES: We assessed stakeholder perceptions on the use of an electronic consultation system (e-Consult) to improve the delivery of kidney care in Alberta. We aim to identify acceptability, barriers and facilitators to the use of an e-Consult system for ambulatory kidney care delivery. METHODS: This was a qualitative focus group study using a thematic analysis design. Eight focus groups were held in four locations in the province of Alberta, Canada. In total, there were 72 participants in two broad stakeholder categories: patients (including patients' relatives) and providers (including primary care physicians, nephrologists, other care providers and policymakers)...
March 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28252877/the-europep-questionnaire-for-patient-s-evaluation-of-general-practice-care-bulgarian-experience
#16
Rositsa Dimova, Rumyana Stoyanova, Donka Keskinova
AIM: To validate the Bulgarian EUROPEP-questionnaire and its implementation to measure patient evaluation of general practice care in Bulgarian population. METHODS: A multicenter cross-sectional study was conducted at twenty five primary care practices from South-Central Region of Bulgaria. A total of 1000 adult patients aged over 18 years and visiting the practice for more than a year were approached consecutively to take part in the study. The internal consistency and test-retest reliability of the EUROPEP questionnaire were evaluated...
February 28, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28247870/teledermatology-in-the-inpatient-setting
#17
Rechelle Tull, Karolyn A Wanat
Teledermatology (TD) is a health care delivery modality that uses telecommunication technology to provide dermatologic care. It has grown to be a reliable and diagnostically accurate means of producing quality care while increasing access and reducing wait times in the outpatient setting. In the inpatient setting, TD may be an effective method to improve access to dermatologic care by remotely triaging, assisting, or providing dermatologic consultative services. For inpatient dermatology, there is the potential for TD to increase access to care in the community setting where dermatologists have full outpatient schedules...
March 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28245880/pre-hospital-ct-diagnosis-of-subarachnoid-hemorrhage
#18
Maren Ranhoff Hov, Annette Ryen, Katrine Finsnes, Janne Storflor, Thomas Lindner, Jostein Gleditsch, Christian Georg Lund
BACKGROUND: Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. CASE PRESENTATION: The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT)...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28243870/disruptive-models-in-primary-care-caring-for-high-needs-high-cost-populations
#19
Michael Hochman, Steven M Asch
Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highlights, there is a compelling need for new care delivery models that would advance these objectives. This need is particularly urgent for high-needs, high-cost (HNHC) populations. By definition, HNHC patients require extensive attention and consume a disproportionate share of resources, and as a result they strain traditional office-based primary care practices...
February 27, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28238501/is-tachycardia-at-discharge-from-the-pediatric-emergency-department-a-cause-for-concern-a%C3%A2-nonconcurrent-cohort-study
#20
Paria M Wilson, Todd A Florin, Guixia Huang, Matthew Fenchel, Matthew R Mittiga
STUDY OBJECTIVE: We evaluate the association between discharge tachycardia and (1) emergency department (ED) and urgent care revisit and (2) receipt of clinically important intervention at the revisit. METHODS: The study included a nonconcurrent cohort of children aged 0 to younger than 19 years, discharged from 2 pediatric EDs and 4 pediatric urgent care centers in 2013. The primary exposure was discharge tachycardia (last recorded pulse rate ≥99th percentile for age)...
February 23, 2017: Annals of Emergency Medicine
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