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Primary care internal medicine

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https://www.readbyqxmd.com/read/29453301/role-of-the-family-doctor-in-the-management-of-adults-with-obesity-a-scoping-review
#1
Elizabeth A Sturgiss, Nicholas Elmitt, Emily Haelser, Chris van Weel, Kirsty A Douglas
OBJECTIVES: Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. SETTING: Primary care. Adult patients. INCLUDED PAPERS: Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors...
February 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29420762/military-internal-medicine-resident-decision-to-apply-to-fellowship-and-extend-military-commitment
#2
Alice E Barsoumian, Joshua D Hartzell, Erin M Bonura, Roseanne A Ressner, Timothy J Whitman, Heather C Yun
Introduction: Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29415655/coping-better-with-health-problems-after-a-visit-to-the-family-physician-associations-with-patients-and-physicians-characteristics
#3
Christine Cohidon, Pascal Wild, Nicolas Senn
BACKGROUND: Good patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients' ability to cope better with their health problems after a family medicine consultation...
February 7, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29415230/factors-influencing-early-referral-early-diagnosis-and-management-in-patients-with-diffuse-cutaneous-systemic-sclerosis
#4
Oliver Distler, Yannick Allanore, Christopher P Denton, Marco Matucci-Cerinic, Janet E Pope, Barbara Hinzmann, Siobhan Davies, Janethe de Oliveira Pena, Dinesh Khanna
Objective: To gain insight into clinical practice regarding referral, early diagnosis and other aspects of the management of patients with dcSSc in Europe and the USA. Methods: Semi-structured interviews were conducted with 84 rheumatologists (or internal medicine physicians) and 40 dermatologists in different countries (the UK, France, Germany, Italy, Spain and the USA). Physicians were asked to identify key steps in the patient pathway relating to patient presentation, diagnosis and referral, in addition to other treatment and follow-up processes...
February 2, 2018: Rheumatology
https://www.readbyqxmd.com/read/29412437/an-international-position-statement-on-the-management-of-frailty-in-diabetes-mellitus-summary-of-recommendations-2017
#5
A J Sinclair, A Abdelhafiz, T Dunning, M Izquierdo, L Rodriguez Manas, I Bourdel-Marchasson, J E Morley, M Munshi, J Woo, B Vellas
AIM: the the International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care. METHODS: the Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the basis of each recommendation...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29406559/lemierres-syndrom-%C3%A2-en-p%C3%A3-minnelse-om-%C3%A2-den-gl%C3%A3-mda-sjukdomen%C3%A2-god-kunskap-under-hela-v%C3%A3-rdkedjan-viktigt-f%C3%A3-r-att-i-tid-v%C3%A3-cka-misstanke
#6
Jan Hedenmark, Karin Holm, Fredrik Moberger, Erik Torell
The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis).  Affected patients present in various fields of medicine and an increased incidence of "the forgotten disease" may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality...
February 2, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29404948/a-randomized-trial-on-the-efficacy-of-mastery-learning-for-primary-care-provider-melanoma-opportunistic-screening-skills-and-practice
#7
June K Robinson, Namita Jain, Ashfaq A Marghoob, William McGaghie, Michael MacLean, Pedram Gerami, Brittney Hultgren, Rob Turrisi, Kimberly Mallett, Gary J Martin
BACKGROUND: Early detection of melanoma represents an opportunity to reduce the burden of disease among people at increased risk for melanoma. OBJECTIVE: To develop and demonstrate the efficacy of online training. DESIGN: Randomized educational trial. PARTICIPANTS: Primary care providers (PCPs). INTERVENTION: Mastery learning course with visual and dermoscopic assessment, diagnosis and management, and deliberate practice with feedback to reach a minimum passing standard...
February 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29404572/association-of-rideshare-based-transportation-services-and-missed-primary-care-appointments-a-clinical-trial
#8
Krisda H Chaiyachati, Rebecca A Hubbard, Alyssa Yeager, Brian Mugo, Stephanie Lopez, Elizabeth Asch, Catherine Shi, Judy A Shea, Roy Rosin, David Grande
Importance: Transportation barriers contribute to missed primary care appointments for patients with Medicaid. Rideshare services have been proposed as alternatives to nonemergency medical transportation programs because of convenience and lower costs. Objective: To evaluate the association between rideshare-based medical transportation and missed primary care appointments among Medicaid patients. Design, Setting, and Participants: In a prospective clinical trial, 786 Medicaid beneficiaries who resided in West Philadelphia and were established primary care patients at 1 of 2 academic internal medicine practices located within the same building were included...
February 5, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29402313/the-improve-gap-trial-aiming-to-improve-evidence-based-management-of-community-acquired-pneumonia-study-protocol-for-a-stepped-wedge-randomised-controlled-trial
#9
Elizabeth H Skinner, Melanie Lloyd, Edward Janus, May Lea Ong, Amalia Karahalios, Terry P Haines, Anne-Maree Kelly, Melina Shackell, Harin Karunajeewa
BACKGROUND: Community-acquired pneumonia is a leading worldwide cause of hospital admissions and healthcare resource consumption. The largest proportion of hospitalisations now occurs in older patients, with high rates of multimorbidity and complex care needs. In Australia, this population is usually managed by hospital inpatient general internal medicine units. Adherence to consensus best-practice guidelines is poor. Ensuring evidence-based care and reducing length of stay may improve patient outcomes and reduce organisational costs...
February 5, 2018: Trials
https://www.readbyqxmd.com/read/29400625/undisclosed-conflicts-of-interests-among-biomedical-textbook-authors
#10
Brian J Piper, Drew A Lambert, Ryan C Keefe, Phoebe U Smukler, Nicolas A Selemon, Zachary R Duperry
BACKGROUND: Textbooks are a formative resource for health care providers during their education and are also an enduring reference for pathophysiology and treatment. Unlike the primary literature and clinical guidelines, biomedical textbook authors do not typically disclose potential financial conflicts of interest (pCoI). The objective of this study was to evaluate whether the authors of textbooks used in the training of physicians, pharmacists, and dentists had appreciable undisclosed pCoI in the form of patents or compensation received from pharmaceutical or biotechnology companies...
February 5, 2018: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/29385577/interprofessional-case-conference-impact-on-learner-outcomes
#11
Jeffrey Sordahl, India C King, Kyle Davis, Rick Tivis, Scott C Smith, Amber Fisher, Janet Willis, Timothy Gordon, William G Weppner
Transition to interprofessional team-based care is a quickly progressing healthcare model and requires changes in medical training approaches. The Department of Veteran Affairs (VA) has taken a lead role in creating such training experiences, one of which is the establishment of multiple Centers of Excellence in Primary Care Education (CoEPCE). These sites are tasked with developing teaching innovations to better facilitate interprofessional team-based care. The patient-aligned care team interprofessional care update (PACT-ICU) is an interprofessional workplace learning activity with the goals of simultaneously addressing educational and patient care needs...
January 27, 2018: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/29380217/physician-perception-of-pay-fairness-and-its-association-with-work-satisfaction-intent-to-leave-practice-and-personal-health
#12
Audiey C Kao, Andrew J Jager, Barbara A Koenig, Arlen C Moller, Michael A Tutty, Geoffrey C Williams, Scott M Wright
BACKGROUND: Primary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health. METHODS: Three thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions...
January 29, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29380214/rideshare-based-medical-transportation-for-medicaid-patients-and-primary-care-show-rates-a-difference-in-difference-analysis-of-a-pilot-program
#13
Krisda H Chaiyachati, Rebecca A Hubbard, Alyssa Yeager, Brian Mugo, Judy A Shea, Roy Rosin, David Grande
BACKGROUND: Transportation to primary care is a well-documented barrier for patients with Medicaid, despite access to non-emergency medical transportation (NEMT) benefits. Rideshare services, which offer greater convenience and lower cost, have been proposed as an NEMT alternative. OBJECTIVE: To evaluate the impact of rideshare-based medical transportation on the proportion of Medicaid patients attending scheduled primary care appointments. DESIGN: In one of two similar practices, all eligible Medicaid patients were offered rideshare-based transportation ("rideshare practice")...
January 29, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29376458/does-an-in-house-internist-at-a-gp-practice-result-in-reduced-referrals-to-hospital-based-specialist-care
#14
Tessa C C Quanjel, Anne Winkens, Marieke D Spreeuwenberg, Jeroen N Struijs, Ron A G Winkens, Caroline A Baan, Dirk Ruwaard
OBJECTIVE: Consistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention. DESIGN: A retrospective interrupted times series study. SETTING: Two multidisciplinary general practitioner (GP) practices...
January 28, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29374389/community-action-research-track-community-based-participatory-research-and-service-learning-experiences-for-medical-students
#15
Nora Gimpel, Tiffany Kindratt, Alvin Dawson, Patti Pagels
Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences...
January 26, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29362276/interdisciplinary-collaboration-across-secondary-and-primary-care-to-improve-medication-safety-in-the-elderly-immense-study-study-protocol-for-a-randomised-controlled-trial
#16
Jeanette Schultz Johansen, Kjerstin Havnes, Kjell H Halvorsen, Stine Haustreis, Lillann Wilsgård Skaue, Elena Kamycheva, Liv Mathiesen, Kirsten K Viktil, Anne Gerd Granås, Beate H Garcia
INTRODUCTION: Drug-related problems (DRPs) are common in the elderly, leading to suboptimal therapy, hospitalisations and increased mortality. The integrated medicines management (IMM) model is a multifactorial interdisciplinary methodology aiming to optimise individual medication therapy throughout the hospital stay. IMM has been shown to reduce readmissions and drug-related hospital readmissions. Using the IMM model as a template, we have designed an intervention aiming both to improve medication safety in hospitals, and communication across the secondary and primary care interface...
January 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29353536/a-progressive-three-phase-innovation-to-medical-education-in-the-united-states
#17
Cory M Pfeifer
The practice of medicine has changed greatly over the past 100 years, yet the structure of undergraduate medical education has evolved very little. Many schools have modified their curricula to incorporate problem-based learning and organ systems-based curricula, but few schools have adequately addressed rising tuition costs. Undergraduate medical education has become cost-prohibitive for students interested in primary care. In the meanwhile, the concept of a separate dedicated intern year is outdated and mired in waste despite remaining a requirement for several hospital-based and surgical specialties...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29338539/primary-care-provider-experience-with-breast-density-legislation-in-massachusetts
#18
Christine M Gunn, Nancy R Kressin, Kristina Cooper, Cinthya Marturano, Karen M Freund, Tracy A Battaglia
BACKGROUND: Dense breasts on mammography independently increases breast cancer risk and decreases mammography sensitivity. Thirty-two states have adopted notification laws to raise awareness among women with dense breasts about supplemental screening. Little is known about these policies' impact on clinical practice among primary care providers (PCPs). MATERIALS AND METHODS: This study explores PCP attitudes, knowledge, and the impact of the Massachusetts dense breast notification legislation on clinical practice after its enactment in 2015...
January 17, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#19
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#20
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
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