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Family practice--urgent care--occupational medicine

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https://www.readbyqxmd.com/read/28633176/determinants-of-the-5-year-retention-and-rural-location-of-family-physicians-results-from-the-iowa-family-medicine-training-network
#1
Gregory C Nelson, Thomas S Gruca
BACKGROUND AND OBJECTIVES: States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). METHODS: Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633168/integration-of-clinical-pharmacists-in-family-medicine-residency-programs
#2
Jody L Lounsbery, Jennie B Jarrett, Lori M Dickerson, Stephen A Wilson
BACKGROUND AND OBJECTIVES: Clinical pharmacists are valued educators and practitioners within family medicine residency programs (FMRPs). Since the last survey of clinical pharmacists within FMRPs, there have been significant advancements to pharmacy education and training as well as growth of interprofessional education and collaborative practice within family medicine. The objective of this study is to describe the integration of clinical pharmacists within FMRPs. METHODS: All 480 Accreditation Council for Graduate Medical Education (ACGME)-approved FMRPs were contacted to identify clinical pharmacists involved with their programs...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28629455/an-investigation-of-the-relationship-between-autonomy-childbirth-practices-and-obstetric-fistula-among-women-in-rural-lilongwe-district-malawi
#3
Julika Ayla Kaplan, Jonathan Kandodo, Joseph Sclafani, Susan Raine, Jennifer Blumenthal-Barby, Alison Norris, Abigail Norris-Turner, Elly Chemey, John Michael Beckham, Zara Khan, Reginald Chunda
BACKGROUND: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor...
June 19, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28622010/-are-you-in-or-are-you-out-moral-appeals-to-the-public-in-organ-donation-poster-campaigns-a-multimodal-and-ethical-analysis
#4
Solveig L Hansen, Marthe I Eisner, Larissa Pfaller, Silke Schicktanz
Organ transplantation is a well-established practice in modern medicine. However, many countries, especially those with an opt-in regulation, face the problem of low donation numbers. Respective public campaigns attempt to increase the number of donors by swaying public opinion with the use of carefully selected bits of information. Germany serves as a case study for an opt-in country investing approximately €7.5 million/year in the distribution of respective campaigns. To address diverse populations, large-scale posters in various public spaces still display a multitude of moral messages for organ donation...
June 16, 2017: Health Communication
https://www.readbyqxmd.com/read/28620736/revisiting-prostate-cancer-screening-practices-among-vermont-primary-care-physicians
#5
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/28617024/evaluating-transformation-with-available-resources-the-influence-of-apex-on-depression-screening
#6
Peter C Smith, Shandra M Brown Levey, Corey Lyon
OBJECTIVE: The University of Colorado developed and piloted a team-based primary care delivery model called ambulatory process excellence (APEX) in a family medicine residency in 2015. We evaluated its impact on depression screening using found data and tools readily available to practice-based evaluators. METHOD: The APEX model calls for 5 medical assistants (MAs) supporting 2 providers. MAs have dedicated time to provide delegated care, including depression screening with 2 versions of the Patient Health Questionnaire: PHQ-2 and PHQ-9...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#7
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617013/the-role-of-policy-in-supporting-clinician-led-research-on-behavioral-health-integration
#8
Nathaniel Z Counts
In Best Care at Lower Cost, the Institute of Medicine laid out a vision for continuously learning health systems (Institute of Medicine of the National Academies, 2016). This issue of Families, Systems, & Health represents a substantial step toward this vision, with on-the-ground clinicians and administrators testing empirically informed hypotheses about practice transformation and population health management, and using those results to produce shared learning within and across systems. While the studies in this issue demonstrate that producing generalizable knowledge from clinician-led initiatives is feasible, they also demonstrate that the current system does not adequately support clinicians in doing so...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28616160/cardiopulmonary-arrest-in-primary-care-clinics-more-holes-than-cheese-a-survey-of-the-knowledge-and-attitudes-of-primary-care-physicians-regarding-resuscitation
#9
Sharon Einav, Oren Wacht, Nechama Kaufman, Eliezer Alkalay
BACKGROUND: Patients experiencing pre-arrest symptoms may first refer to their primary care physician. The study's aim was to determine the likelihood that a patient undergoing out-of-hospital cardiac arrest will receive appropriate resuscitation efforts in a primary care clinic in a country with a directive that clinics maintain resuscitation equipment and physicians undergo periodic resuscitation training. METHODS: An anonymous, 23-question online cross-sectional survey was created and administered to primary care physicians working in community clinics (10/1/2015-5/3/2015)...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28606370/factors-influencing-pediatrician-retirement-a-survey-of-american-academy-of-pediatrics-chapter-members
#10
Mary E Rimsza, Holly Ruch-Ross, Harold K Simon, Thomas W Pendergass, Holly J Mulvey
OBJECTIVE: To assess the factors that may influence physicians' desire to retire through an analysis of data collected through the American Academy of Pediatrics (AAP) State Pediatrician Workforce Survey. STUDY DESIGN: An electronic survey was sent to retired and nonretired US pediatricians who held AAP membership. The respondents were asked about the importance of 12 factors that would influence or had influenced their decision to retire. The physicians who were not yet retired also were asked: "If you could afford to today, would you retire from medicine?" RESULTS: The survey was completed by 8867 pediatricians...
June 9, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28600490/treating-tobacco-dependence-guidance-for-primary-care-on-life-saving-interventions-position-statement-of-the-ipcrg
#11
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/28600199/financing-of-vaccine-delivery-in-primary-care-practices
#12
Mandy A Allison, Sean T O'Leary, Megan C Lindley, Lori A Crane, Laura P Hurley, Brenda L Beaty, Michaela Brtnikova, Andrea Jimenez-Zambrano, Christine Babbel, Stephen Berman, Allison Kempe
OBJECTIVES: Vaccines represent a significant portion of primary care practices' expenses. Our objectives were to determine among Pediatric (Ped) and Family Medicine (FM): 1) relative payment for vaccine purchase and administration and estimated profit margin by payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines due to finances. METHODS: A national survey conducted April-September 2011 among Ped and FM in private, single-specialty practices...
June 6, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28598866/using-qualitative-research-to-inform-development-of-professional-guidelines-a-case-study-of-the-society-of-critical-care-medicine-family-centered-care-guidelines
#13
Maureen A Coombs, Judy E Davidson, Mark E Nunnally, Mary A Wickline, J Randall Curtis
OBJECTIVES: To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. METHODS: In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research...
June 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28595441/healing-spirituality-and-integrative-medicine
#14
David M Steinhorn, Jana Din, Angela Johnson
Spirituality plays a prominent role in the lives of most palliative patients whether or not they formally adhere to a specific religion and belief. As a result, the palliative care team is frequently called upon to support families who are experiencing their "dark night of the soul" and struggling to make sense of their lives during a healthcare crisis. While conventional religious practices provide a source of comfort and guidance for many of our patients, a significant number of our patients do not have a strong religious community to which to turn...
May 22, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28592581/the-stop-ab-trial-protocol-efficacy-and-safety-of-discontinuing-patient-antibiotic-treatment-when-physicians-no-longer-consider-it-necessary
#15
Carl Llor, Ana Moragas, Carolina Bayona, Josep M Cots, José M Molero, Joana Ribas, Julio Francisco Fóthy, Isabel Gutiérrez, Coro Sánchez, Jesús Ortega, Javier Arranz, Jenifer Botanes, Purificación Robles
INTRODUCTION: Since 2011, the Spanish Society of Family Medicine has recommended general practitioners (GPs) to ask their patients to stop taking antibiotics when they suspect a viral infection. However, this practice is seldom used because uncertainty about diagnosis, and fear of consequences of discontinuing antibiotic therapy, as well as perceived pressure to continue prescribing antibiotics and potential conflict with patients are more of a concern for GPs than antibiotic resistance...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28592480/implementing-family-centered-care-through-facilitated-sensemaking
#16
Judy E Davidson, Sidney Zisook
The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28592474/implementing-intensive-care-unit-family-centered-care-resources-to-identify-and-address-gaps
#17
David Y Hwang, Robert El-Kareh, Judy E Davidson
During creation of the 2017 Society of Critical Care Medicine Guidelines for Family-Centered Care in the Intensive Care Unit, 2 implementation tools were developed to assist intensive care unit clinicians in incorporating the new recommendations into local practice: a gap analysis tool and a work tools document. The gap analysis tool helps intensive care unit teams rapidly develop unit- or organization-specific recommendations to enhance family-centered care and assess local barriers to implementation. The work tools document identifies readily available and tested resources that may further assist with action planning for change...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28592473/implementing-the-sccm-family-centered-care-guidelines-in-critical-care-nursing-practice
#18
Maureen Coombs, Kathleen A Puntillo, Linda S Franck, Elizabeth A Scruth, Maurene A Harvey, Sandra M Swoboda, Judy E Davidson
Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28578448/topical-corticosteroids-knowledge-attitudes-and-practices-of-primary-care-physicians
#19
Sarah F Alsukait, Najd M Alshamlan, Zeina Z Alhalees, Sami N Alsuwaidan, Abdulmajeed M Alajlan
To assess knowledge, attitudes, and practices of primary care physicians (PCPs) toward topical corticosteroids (TCs). Methods: A cross-sectional, 53-item questionnaire based study on TCs was conducted among PCPs in Riyadh, Kingdom of Saudi Arabia between January and March 2015. A maximum score of 30 was calculated for the knowledge portion. Results: Out of 420 PCPs, 336 responded (80%). Most participants (89.6%) reported prescribing TCs. The mean knowledge score was 17.14 (SD=5.48). Only 39% PCPs correctly identified that there are 7 or 4 TCs potency groups (2 different classification systems)...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28577866/multimorbidity-patterns-in-older-adults-an-approach-to-the-complex-interrelationships-among-chronic-diseases
#20
Dolores Mino-León, Hortensia Reyes-Morales, Svetlana V Doubova, Ricardo Pérez-Cuevas, Liliana Giraldo-Rodríguez, Marcela Agudelo-Botero
BACKGROUND AND AIMS: There is a growing need for evidence based answers to multimorbidity, especially in primary care settings. The aim was estimate the prevalence and patterns of multimorbidity in a Mexican population of public health institution users ≥60 years old. METHODS: Observational and multicenter study was carried out in four family medicine units in Mexico City; included older men and women who attended at least one consultation with their family doctor during 2013...
January 2017: Archives of Medical Research
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