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Primary care internal medicine

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https://www.readbyqxmd.com/read/28323547/the-extent-that-health-professionals-suspect-and-address-addiction-to-medicines-in-primary-care-findings-from-a-survey-in-northwest-england
#1
Geoff Bates, Madeleine Cochrane, Adam John Mackridge
Addiction to medicines available over the counter or via prescription is of growing international concern. The authors of the current article ran an online survey of health professionals in general medical practice and community pharmacy settings in Northwest England to explore the frequency of suspecting and responding to addiction to medicines. Health professionals reported frequently identifying addiction to medicines among patients including those with long-term pain, mental health problems, sleep disorders, and other substance use disorders, but that these addictions often go unchallenged...
March 1, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28317473/the-columbia-bronx-va-amalgamative-clerkship-an-effective-12-week-integrated-longitudinal-clinical-experience
#2
Jillian Diuguid-Gerber, Samuel Porter, Samuel C Quiah, Katherine Nickerson, Deborah Jones, Zeena Audi, Boyd F Richards
BACKGROUND: Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. OBJECTIVE: In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC)...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28300986/primary-health-care-quality-in-rocinha-rio-de-janeiro-brazil-from-the-perspective-of-children-caregivers-and-adult-users
#3
Luiz Felipe Pinto, Erno Harzheim, Lisiane Hauser, Otávio Pereira D'Avila, Marcelo Rodrigues Gonçalves, Paula Travassos, Renan Pessanha
This paper aims to evaluate the extent of PHC attributes, from the experience of users, both adults and children caregivers, comparing the area served by the health facilities of the district of Rocinha with other areas of health district 2.1 in the municipality of Rio de Janeiro. The measuring tool used to evaluate the quality of services provided was the Primary Care Assessment Tools. A cross-sectional study was conducted, with independent random samples and 802 interviewees. Results indicate a better performance for children care when compared to adult care...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28293671/pilot-phase-evaluation-of-the-elective-general-practice-class-results-of-student-surveys-of-the-first-two-years
#4
Franziska-Antonia Samos, Marcus Heise, Stephan Fuchs, Susanne Mittmann, Alexander Bauer, Andreas Klement
Background: Primary health care in rural regions is currently undergoing a global crisis in respect of the next generation of practitioners. National and international recommendations advise placing greater emphasis upon practical skills and competences in medical studies. It is also in the interest of training the next generation to include mentoring and longitudinal integration of contact to teaching practices for general medicine in an early stage. Consequently, the General Practice Class (KAM) was introduced in Halle in 2011 as an elective with 20 individually mentored students per year, beginning with the first subject-related semester...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#5
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28283121/health-care-expenditures-associated-with-pollution-exploratory-methods-and-findings
#6
Alexander S Preker, Olusoji O Adeyi, Marisa Gil Lapetra, Diane-Charlotte Simon, Eric Keuffel
BACKGROUND: The research done for this paper is part of the background analysis undertaken to support the work of the Global Commission on Pollution, Health and Development, an initiative of The Lancet, the Global Alliance on Health and Pollution, and the Icahn School of Medicine at Mount Sinai. The paper expands on areas where the current literature has gaps in knowledge related to the health care cost of pollution. OBJECTIVES: This study aims to generate an initial estimate of total tangible health care expenditure attributable to man-made pollution affecting air, soil and water...
September 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28257475/awareness-and-attitudes-of-pre-exposure-prophylaxis-for-hiv-prevention-among-physicians-in-guatemala-implications-for-country-wide-implementation
#7
Ian Ross, Carlos Mejia, Johanna Melendez, Philip A Chan, Amy C Nunn, William Powderly, Katherine Goodenberger, Jingxia Liu, Kenneth H Mayer, Rupa R Patel
INTRODUCTION: HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP...
2017: PloS One
https://www.readbyqxmd.com/read/28254470/tackling-inpatient-penicillin-allergies-tools-for-antimicrobial-stewardship
#8
Kimberly G Blumenthal, Paige G Wickner, Shelley Hurwitz, Nicholas Pricco, Alexandra E Nee, Karl Laskowski, Erica S Shenoy, Rochelle P Walensky
BACKGROUND: Reported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events. OBJECTIVE: We aimed to determine the optimal approach to penicillin allergies among medical inpatients. METHODS: We evaluated internal medicine inpatients reporting penicillin allergy in three periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP)...
February 27, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28253540/payment-methods-for-outpatient-care-facilities
#9
REVIEW
Beibei Yuan, Li He, Qingyue Meng, Liying Jia
BACKGROUND: Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28225542/historical-overview-of-leprosy-control-in-cuba
#10
Enrique Beldarraín-Chaple
INTRODUCTION Leprosy, an infectious disease caused by Mycobacterium leprae, affects the nervous system, skin, internal organs, extremities and mucous membranes. Biological, social and environmental factors influence its occurrence and transmission. The first effective treatments appeared in 1930 with the development of dapsone, a sulfone. The main components of a control and elimination strategy are early case detection and timely administration of multidrug therapy. OBJECTIVES Review the history of leprosy control in Cuba, emphasizing particularly results of the National Leprosy Control Program, its modifications and influence on leprosy control...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#11
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28218404/topical-medication-instillation-techniques-for-glaucoma
#12
REVIEW
Li Xu, Xuemei Wang, Meijing Wu
BACKGROUND: Glaucoma is a leading cause of irreversible blindness worldwide and the second most common cause of blindness after cataracts. The primary treatment for glaucoma aims to lower intraocular pressure (IOP) with the use of topical medicines. Topical medication instillation techniques, such as eyelid closure and nasolacrimal occlusion when instilling drops, have been proposed as potential methods to increase ocular absorption and decrease systemic absorption of the drops. OBJECTIVES: To investigate the effectiveness of topical medication instillation techniques compared with usual care or another method of instillation of topical medication in the management of glaucoma or ocular hypertension...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#13
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28188149/multilayered-and-digitally-structured-presentation-formats-of-trustworthy-recommendations-a-combined-survey-and-randomised-trial
#14
Linn Brandt, Per Olav Vandvik, Pablo Alonso-Coello, Elie A Akl, Judith Thornton, David Rigau, Katie Adams, Paul O'Connor, Gordon Guyatt, Annette Kristiansen
OBJECTIVES: To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format-compared to a standard format-as well as conceptual understanding of trustworthy guideline concepts. DESIGN: Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers...
February 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28175979/mind-the-treatment-gap-a-global-perspective-on-current-and-future-strategies-for-prevention-of-fragility-fractures
#15
REVIEW
N C W Harvey, E V McCloskey, P J Mitchell, B Dawson-Hughes, D D Pierroz, J-Y Reginster, R Rizzoli, C Cooper, J A Kanis
This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all...
February 7, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28162853/the-cost-of-topical-immunomodulator-therapy-in-medicare-patients-varies-by-prescriber-specialty
#16
Myron Zhang, Jonathan I Silverberg, Benjamin H Kaffenberger
BACKGROUND: Topical immunomodulators (TI)-including corticosteroids, calcineurin inhibitors, and vitamin D analogues-are commonly prescribed in multiple specialties, but cost comparisons are lacking. OBJECTIVE: To evaluate differences in costs of TI across specialties and determine associated variables. METHODS: A cross-sectional study was performed using the Centers for Medicare & Medicaid Services 2008 and 2010 Prescription Drug Public Use Profiles, which contain 100% of drug claims made by Medicare beneficiaries...
February 2, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28156520/the-i-one-trial-integrative-oncology-education-for-patient-navigators-a-randomized-pilot-trial-of-web-based-distance-learning-with-or-without-small-group-retreat
#17
Karen Beard, Yuan Liu, Alice S Kerber
171 Background: One of the major barriers to implementation of an integrative oncology (IO) approach is appropriately trained providers. This trial investigated the effectiveness of a mixed method educational program versus web based learning only for oncology patient navigators relative to knowledge and application of IO modalities. METHODS: Patient navigators were randomized 1:1 to Web based education only (WEB) vs. WEB plus residential retreat (WEB+R). The trial was conducted as a randomized, two-group, pre-test/post-test design with 4 repeated measures...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155289/conference-report-undergraduate-family-medicine-and-primary-care-training-in-sub-saharan-africa-reflections-of-the-primafamed-network
#18
Innocent Besigye, Robert Mash, Akye Essuman, Maaike Flinkenflögel
Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016...
January 30, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28152847/lung-cancer-screening-knowledge-and-beliefs-among-primary-care-providers-and-pulmonologists
#19
Mikael Anne Greenwood-Hickman, Laura Jones, M Patricia Rivera, J Michael Bowling, Paul Molina, Susan Maygarden, Katherine Birchard, Dan Reuland, Louise Henderson
191 Background: In response to the National Lung Screening Trial's findings, numerous professional organizations have published guidelines recommending annual lung cancer (LC) screening with low dose computed tomography (LDCT) for eligible patients. In the wake of these guidelines, we sought to assess LC screening practices and beliefs among providers at a large academic medical center. METHODS: In 2015, we surveyed 54 physicians and 9 residents in pulmonology (27% response rate) and 86 physicians and 100 residents in family/internal medicine (39% response rate)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149323/the-european-network-on-psychosomatic-medicine-enpm-history-and-future-directions
#20
REVIEW
Hans-Christian Deter, Kristina Orth-Gomér, Bohdan Wasilewski, Ramiro Verissimo
BACKGROUND: Within national and international societies of psychosomatic medicine the idea has emerged of bringing together and coordinating psychosomatic, behavioural, psychological and medical actions with common interests throughout Europe as a way to increase their scientific and political influence. METHODS: It was felt that there was a strong need and opportunity of a common and unifying forum for scientific exchange. RESULTS: It was considered desirable to exchange scientific thoughts and experiences in an open minded and boundless way, among individuals and societies, between disciplines and across borders...
2017: BioPsychoSocial Medicine
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