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Primary care internal medicine

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https://www.readbyqxmd.com/read/28647679/factors-impacting-on-psychological-wellbeing-of-international-students-in-the-health-professions-a-scoping-review
#1
REVIEW
Lisa McKenna, Eddie Robinson, Joy Penman, Danny Hills
BACKGROUND: There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. OBJECTIVES: To explore what is known about factors that influence the psychological wellbeing of international students in the health professions...
June 17, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28626850/prescribing-indicators-in-primary-health-care-in-belo-horizonte-brazil-associated-factors
#2
Marina Guimarães Lima, Kátia Reis Dutra, Ursula Carolina Morais Martins
Background The prescription is one of the factors that influences rational use of medicines. The evaluation of prescribing indicators should contribute to organization of primary health care services. Objective The aim of this study was to evaluate prescribing indicators and associated factors in primary health care in the northeast health district, Belo Horizonte, Brazil. Setting Twenty primary health care units in the Northeast Health District, Belo Horizonte, Brazil. Method The study was cross sectional...
June 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#3
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28620736/revisiting-prostate-cancer-screening-practices-among-vermont-primary-care-physicians
#4
Laura Donnelly, Kevan M Sternberg, Takamaru Ashikaga, Mark K Plante, Scott D Perrapato
The objective of this study was to assess the prostate cancer screening practices of Vermont primary care physicians and compare them with a prior study in 2001. An electronic survey was created and emailed to all currently practicing primary care physicians in Vermont. Data was stratified by practice length, practice location, university affiliation, and internal medicine versus family practice. Surveys were received from 123 (27.2%) primary care physicians. 27.7% of physicians in practice <10 years recommended prostate specific antigen (PSA) testing, compared with 55...
June 15, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28609535/comparison-of-content-on-the-american-board-of-internal-medicine-maintenance-of-certification-examination-with-conditions-seen-in-practice-by-general-internists
#5
Bradley Gray, Jonathan Vandergrift, Rebecca S Lipner, Marianne M Green
Importance: Success on the internal medicine (IM) examination is a central requirement of the American Board of Internal Medicine's (ABIM's) Maintenance of Certification program (MOC). Therefore, it is important to understand the degree to which this examination reflects conditions seen in practice, one dimension of content validity, which focuses on the match between content in the discipline and the topics on the examination questions. Objective: To assess whether the frequency of questions on IM-MOC examinations were concordant with the frequency of conditions seen in practice...
June 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#6
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28606975/drivers-of-expenditure-on-primary-care-prescription-drugs-in-10-high-income-countries-with-universal-health-coverage
#7
Steven G Morgan, Christine Leopold, Anita K Wagner
BACKGROUND: Managing expenditures on pharmaceuticals is important for health systems to sustain universal access to necessary medicines. We sought to estimate the size and sources of differences in expenditures on primary care medications among high-income countries with universal health care systems. METHODS: We compared data on the 2015 volume and cost per day of primary care prescription drug therapies purchased in 10 high-income countries with various systems of universal health care coverage (7 from Europe, in addition to Australia, Canada and New Zealand)...
June 12, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28600490/treating-tobacco-dependence-guidance-for-primary-care-on-life-saving-interventions-position-statement-of-the-ipcrg
#8
O C P Van Schayck, S Williams, V Barchilon, N Baxter, M Jawad, P A Katsaounou, B J Kirenga, C Panaitescu, K W I G Tsiligianni, N Zwar, A Ostrem
Tobacco smoking is the world's leading cause of premature death and disability. Global targets to reduce premature deaths by 25% by 2025 will require a substantial increase in the number of smokers making a quit attempt, and a significant improvement in the success rates of those attempts in low, middle and high income countries. In many countries the only place where the majority of smokers can access support to quit is primary care. There is strong evidence of cost-effective interventions in primary care yet many opportunities to put these into practice are missed...
June 9, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28588112/the-hoorn-diabetes-care-system-dcs-cohort-a-prospective-cohort-of-persons-with-type-2-diabetes-treated-in-primary-care-in-the-netherlands
#9
Amber Awa van der Heijden, Simone P Rauh, Jacqueline M Dekker, Joline W Beulens, Petra Elders, Leen M 't Hart, Femke Rutters, Nienke van Leeuwen, Giel Nijpels
PURPOSE: People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort. PARTICIPANTS: The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28579813/evaluation-of-the-treatment-patterns-and-economic-burden-of-dysmenorrhea-in-japanese-women-using-a-claims-database
#10
Sayako Akiyama, Erika Tanaka, Olivier Cristeau, Yoshie Onishi, Yutaka Osuga
PURPOSE: This study aimed to describe treatment patterns and estimate health care resource utilization and associated costs among Japanese women with dysmenorrhea, using a claims database. METHODS: This was a retrospective analysis using health insurance data from the Japan Medical Data Center, assessing female patients aged 18-49 years with newly diagnosed primary or secondary dysmenorrhea. Treatment pattern analyses focused on hormonal medications, analgesics, hemostatic agents, traditional Chinese medicine (TCM), and gynecological surgeries...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28554095/the-association-between-red-cell-distribution-width-and-poor-outcomes-in-hospitalized-patients-with-influenza
#11
Guy Topaz, Yona Kitay-Cohen, Lee Peled, Wesal Gharra, Keren Kaminer, Mayan Eitan, Lamis Mahamid, Lotan Shilo
PURPOSE: To examine an association between red blood cell distribution width (RDW) and the prognosis of influenza patients. METHODS: We conducted a retrospective analysis of patients hospitalized with influenza during 2012-2015 in the internal medicine wards of one medical center. RDW measurements during hospitalization were analyzed. Primary outcome was complicated hospitalization (defined as at least one of: length of stay ≥7days, need for mechanical ventilation, septic shock, transfer to intensive-care, or 30-day mortality)...
May 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28551929/-early-in-hospital-mortality-in-internal-medicine-wards-within-24-hours-a-potential-quality-indicator-or-a-variable-affected-by-multiple-factors
#12
Yaron Niv, Evgeny Berkov, Pazit Kanter, Evgeny Abrahmson, Uri Gabbay
AIMS: To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator. BACKGROUND: In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals. Research on mortality within 24 hours had not been published. METHODS: An historical prospective study was conducted including the entire internal wards admissions to the Rabin Medical Center between 1/7/14 and 30/6/15...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28547268/primary-care-providers-experience-management-and-referral-patterns-regarding-pelvic-floor-disorders-a-national-survey
#13
Donna Mazloomdoost, Catrina C Crisp, Steven D Kleeman, Rachel N Pauls
INTRODUCTION AND HYPOTHESIS: Primary care physicians can impact womens' access to care. We assessed primary care providers' experience and management regarding pelvic floor disorders. METHODS: This Institutional Review Board approved study invited internal and family Medicine Program Directors to complete and distribute to faculty an online survey designed to query demographics, perceptions, management, and referral patterns regarding urinary incontinence (UI), overactive bladder (OAB), and pelvic organ prolapse (POP) in females...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28546866/a-diagnostic-protocol-designed-for-determining-allergic-causes-in-patients-with-blood-eosinophilia
#14
Jean-François Magnaval, Guy Laurent, Noémie Gaudré, Judith Fillaux, Antoine Berry
BACKGROUND: Blood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at Toulouse University Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated investigations...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28545400/the-role-of-a-behavioural-medicine-intervention-in-physiotherapy-for-the-effects-of-rehabilitation-outcomes-in-exercise-based-cardiac-rehabilitation-ecra-the-study-protocol-of-a-randomised-controlled-trial
#15
Sabina Borg, Birgitta Öberg, Lennart Nilsson, Anne Söderlund, Maria Bäck
BACKGROUND: To help patients with coronary artery disease (CAD) benefit from the positive health effects attained by exercise-based cardiac rehabilitation (CR), adherence to these programmes according to international guidelines is important. Strategies to increase adherence to exercise-based CR are mainly an unexplored area. The objective of this study is to investigate the effects of a behavioural medicine intervention in physiotherapy, containing goal-setting, self-monitoring and feedback, with the aim of improving rehabilitation outcomes for exercise-based CR, compared with usual care...
May 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28535316/residents-confidence-providing-primary-care-with-behavioral-health-integration
#16
Patrick Hemming, Amber Hewitt, Joseph J Gallo, Rodger Kessler, R B Levine
BACKGROUND AND OBJECTIVES: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#17
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#18
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28531787/clinical-nutrition-in-primary-care-an-evaluation-of-resident-physicians-attitudes-and-self-perceived-proficiency
#19
Sarah L Han, Reto Auer, Jacques Cornuz, Pedro Marques-Vidal
BACKGROUND & AIMS: There is little information regarding the impact of clinical nutrition training among medical residents. We aimed to evaluate the attitudes, self-perceived proficiency and knowledge of Swiss residents regarding clinical nutrition. METHODS: Cross-sectional study conducted between June and September 2014 in two medical education facilities located in Lausanne, Switzerland. Attitudes, self-perceived proficiency and knowledge regarding clinical nutrition were assessed by questionnaire...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28507284/melanoma-masquerading-as-a-zosteriform-rash
#20
Saif Ibrahim, Bashar Al-Turk, Ciel Harris, Farrah Al-Saffar, Sayf Said, Maheera Farsi, Jeffrey Winder, Christian Landa
BACKGROUND Primary care physicians and internal medicine specialists frequently encounter a variety of rashes. Many of these cases look and feel typical of common entities, resulting in the potential for misdiagnosis. CASE REPORT This is a case of a zosteriform rash where the surprising true diagnosis of metastatic melanoma was confirmed with bedside skin punch biopsy. Possible mechanisms involve direct cutaneous injury, neuronal, and dorsal root ganglia involvement in metastases. CONCLUSIONS Skin biopsy is indispensable especially when there is a lack of clinical response or deterioration in the clinical condition...
May 16, 2017: American Journal of Case Reports
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