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C Liam Dwyer, Maximillian Soong, Alice Hunter, Jesse Dashe, Eric Tolo, N George Kasparyan
PURPOSE: We investigated whether written guidelines for surgeons and educational handouts for patients regarding safe and effective opioid use after hand surgery could reduce prescription sizes while achieving high patient satisfaction and a low refill rate. METHODS: All patients undergoing isolated carpal tunnel release or distal radius volar locked plating in a hand surgery group practice during a 6-month period were prospectively enrolled. Surgeons prescribed analgesics at their own discretion based on written guidelines...
March 12, 2018: Journal of Hand Surgery
Lara Hart, Humaira Nael, Natasha M Longmire, Mary Zachos
BACKGROUND: A well-visualized colon during colonoscopy has a direct impact on interpretation of findings and need for repeat procedure. Studies have been conducted in the adult population to assess factors contributing to improved bowel preparation. The primary aim of this study was to determine barriers and facilitators to good preparation in children. METHODS: A qualitative descriptive approach was utilized. Children age 2 to 18 years old, and their parents were recruited from the McMaster University Gastroenterology clinic from May 2015 to January 2016...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
Shanina C Knighton, Mary Dolansky, Curtis Donskey, Camille Warner, Herleen Rai, Patricia A Higgins
BACKGROUND: We hypothesized that the addition of a novel verbal electronic audio reminder to an educational patient hand hygiene bundle would increase performance of self-managed patient hand hygiene. METHODS: We conducted a 2-group comparative effectiveness study randomly assigning participants to patient hand hygiene bundle 1 (n = 41), which included a video, a handout, and a personalized verbal electronic audio reminder (EAR) that prompted hand cleansing at 3 meal times, or patient hand hygiene bundle 2 (n = 34), which included the identical video and handout, but not the EAR...
March 1, 2018: American Journal of Infection Control
Rosy Chhabra, Deena J Chisolm, Barbara Bayldon, Maheen Quadri, Iman Sharif, Jessica J Velazquez, Karen Encalada, Angelic Rivera, Millie Harris, Elana Levites-Agababa, H Shonna Yin
BACKGROUND AND OBJECTIVES: Despite recommendations supporting human papillomavirus (HPV) vaccination, pediatric vaccination rates remain suboptimal in the United States; lack of tools to support provider counseling is one barrier. We sought to evaluate HPV-related counseling materials for readability, suitability, and content, and assess parent perceptions of materials, using a health literacy perspective. METHODS: A systematic search was conducted for written materials developed for HPV vaccination counseling by examining state Department of Health Web sites and associated links to local and national organizations...
March 2018: Academic Pediatrics
Megan B Shannon, W Adams, C M Fitzgerald, E R Mueller, L Brubaker, C Brincat
OBJECTIVES: The objective of this study was to evaluate patient attendance and preparedness for pelvic floor physical therapy (PFPT) after comparing standard counseling versus standard counseling plus an educational video. METHODS: A randomized controlled trial of 200 patients in a Female Pelvic Medicine and Reconstructive Surgery practice was performed in a tertiary care referral center. Participants were randomized to 1 of 2 educational modalities after being prescribed PFPT...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Marcie Berman, Frances Bozsik, Robin P Shook, Emily Meissen-Sebelius, Deborah Markenson, Shelly Summar, Emily DeWit, Jordan A Carlson
PURPOSE AND OBJECTIVES: Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families. INTERVENTION APPROACH: The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children's hospital...
February 22, 2018: Preventing Chronic Disease
Daniel M Walker, Terri Menser, Po-Yin Yen, Ann Scheck McAlearney
BACKGROUND:  Patient portals specifically designed for the inpatient setting have significant potential to improve patient care. However, little is known about how the users of this technology, the patients, may interact with the inpatient portals. As a result, hospitals have limited ability to design approaches that support patient use of the portal. OBJECTIVES:  This study aims to evaluate the user experience associated with an inpatient portal. METHODS:  We used a Think-Aloud protocol to study user interactions with a commercially available inpatient portal-MyChart Bedside (MCB)...
January 2018: Applied Clinical Informatics
Shira Goldstein, Richard Hubbard
BACKGROUND AND OBJECTIVES: Effective public provision of contraceptive services depends upon regular interventions at the primary care level. Recognizing the need to improve the frequency and quality of contraceptive counseling at a rural family medicine residency, this study sought to determine if the introduction of a simple teaching tool would lead to an increase in the rates of such counseling. METHODS: Resident physicians at a rural clinic provided contraceptive counseling to all eligible women, utilizing a simple educational table as a teaching aid...
February 2018: Family Medicine
Julie M Cavallario, Bonnie L Van Lunen, Johanna M Hoch, Matthew Hoch, Sarah A Manspeaker, Shana L Pribesh
CONTEXT: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. OBJECTIVE: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters...
February 8, 2018: Journal of Athletic Training
Kathleen J Porter, Ramine Alexander, Katelynn M Perzynski, Natalie Kruzliakova, Jamie M Zoellner
Ensuring that written materials used in behavioral interventions are clear is important to support behavior change. This study used the Clear Communication Index (CCI) to assess the original and revised versions of three types of written participant materials from the SIPsmartER intervention. Materials were revised based on original scoring. Scores for the entire index were significantly higher among revised versions than originals (57% versus 41%, p < 0.001); however, few revised materials (n = 2 of 53) achieved the benchmark of ≥90%...
February 8, 2018: Health Communication
Kathryn E Kanzler, Patricia J Robinson, Donald D McGeary, Jim Mintz, Jennifer Sharpe Potter, Mariana Muñante, Eliot J Lopez, Donald M Dougherty, Willie J Hale, Dawn I Velligan
Most of the 100 million Americans with persistent pain are treated in primary care clinics, but evidence-based psychosocial approaches targeting pain-related disability are not usually provided in these settings. This manuscript describes the rationale and methods for a protocol to pilot test the feasibility and effectiveness of Acceptance and Commitment Therapy (ACT), an evidence-based psychological treatment for persistent pain, delivered by a Behavioral Health Consultant in primary care. Eligible patients are identified through electronic health record registries and invited to participate via secure messaging, letters and a follow-up phone call...
January 27, 2018: Contemporary Clinical Trials
Amy A Gorin, Erin M Lenz, Talea Cornelius, Tania Huedo-Medina, Alexis C Wojtanowski, Gary D Foster
OBJECTIVE: For married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program. METHODS: One hundred thirty dyads were randomized to Weight Watchers (WW; n = 65) or to a self-guided control group (SG; n = 65) and assessed at 0, 3, and 6 months. Inclusion criteria were age ≥ 25 years, BMI 27 to 40 kg/m 2 (≥ 25 kg/m 2 for untreated spouses), and no weight loss contraindications...
February 1, 2018: Obesity
Jeffrey Guina, Brian Merrill
This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision-sometimes mutually agreed-upon and sometimes unilateral-to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e...
January 30, 2018: Journal of Clinical Medicine
Kyung E Rhee, Stephanie Kessl, Sarah Lindback, Marshall Littman, Robert E El-Kareh
BACKGROUND: Pediatric providers are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. The goal of this study was to examine the views of pediatric providers on conducting obesity management in the primary care setting, and identify potential resources and care models that could facilitate delivery of this care. METHODS: A mixed methods approach was utilized. Four focus groups were conducted with providers from a large pediatric network in San Diego County...
January 30, 2018: BMC Health Services Research
Anita Singhal
Background: Microbiology is usually taught by conventional lectures, and its retention and application is observed to be poor among medical graduates/practitioners. Aim and Objectives: Introduction of case-based learning (CBL) in microbiology for second-year professional MBBS students. Materials and Methods: Students were divided into two groups of fifty each. Four clinical cases were used for CBL. One group had two CBL sessions whereas the other had didactic lectures (DLs) and then the groups were crossed over...
December 2017: International Journal of Applied and Basic Medical Research
Mark P Doescher, Ming Wu, Elizabeth Rainwater, Ali S Khan, Dorothy A Rhoades
PURPOSE: Patient preferences regarding the role of the primary care provider (PCP) in discussing electronic cigarette (e-cigarette) use are unknown. METHODS: We administered a cross-sectional survey to 568 adult patients in a family medicine clinic to explore e-cigarette use, sources of information on e-cigarettes, perceived knowledge about e-cigarette health effects, views regarding PCP knowledge of e-cigarettes, interest in discussing e-cigarettes with PCPs and preferred format for e-cigarette information...
January 2018: Journal of the American Board of Family Medicine: JABFM
Cristina Silva, Ana Teresa Almeida-Santos, Cláudia Melo, Ana Cristina Ribeiro Rama
PURPOSE: Infertility is a potential adverse effect of cancer treatment, and future fertility is an important issue for cancer patients. In Portugal, the Centre for Fertility Preservation of CHUC, EPE, conducted a project to develop and disseminate oncofertility information resources. In this study, we report the results of the specific component of this program, which intended to produce information resources that promote patients' awareness of the subject and to support decisions concerning fertility preservation...
January 3, 2018: Journal of Adolescent and Young Adult Oncology
Rachel A Burton, Rebecca A Peters, Kelly J Devers
BACKGROUND: The most frequently pursued intervention in the $100 million, 18-state Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) quality demonstration (2010-2015) was quality improvement collaboratives, which 12 states offered to more than 300 primary care practices. A study was conducted to identify which aspects of these collaboratives were viewed by organizers and participants as working well and which were not. METHODS: Some 223 interviews were conducted in these states near the end of their collaboratives...
January 2018: Joint Commission Journal on Quality and Patient Safety
Nymisha Chilukuri, Tina L Cheng, Kevin J Psoter, Kamila B Mistry, Katherine A Connor, Daniel J Levy, Krishna K Upadhya
OBJECTIVE: To assess the impact of provision of folate vitamins and a preconception health intervention on folate use among mothers bringing infants to pediatric primary care. STUDY DESIGN: We conducted a cluster randomized trial in mothers presenting with their infants (<12 months) at 4 urban pediatric practices in the Baltimore, Maryland, metropolitan area. There were 45 clinicians randomized into an intervention group (15-item preconception health screening and counseling and 90-day multivitamin supply) and control group (preconception health and community resource handouts and 90-day multivitamin supply)...
January 2018: Journal of Pediatrics
Lisa Smith, Benjamin Kyle Hansen, Emily Heubel
OBJECTIVE: To describe common teaching activities included in post-graduate residencies, identify residents' self-perceived ability to perform the activities, and report characteristics of residents who did not feel post-graduate residency training prepared them for an academic career. METHODS: Residency Directors of PGY-2 ASHP-accredited U.S. residency programs in the July 2013-June 2014 cycle were asked to forward a 16-item online survey to PGY-2 residents. The survey was designed to determine teaching activities from a list of 21 common activities and measure self-perception of skill development...
March 2017: Currents in Pharmacy Teaching & Learning
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