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Family practice--urgent care--occupational medicine

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https://www.readbyqxmd.com/read/29341818/medicine-as-it-should-be-teaching-team-and-teamwork-during-a-palliative-care-clerkship
#1
Barbara A Head, Christian Davis Furman, Andrew M Lally, Kimberly Leake, Mark Pfeifer
BACKGROUND: Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. OBJECTIVE: Our objective was to assess the learning of senior medical students during a palliative care rotation. DESIGN: A constant comparison method based on grounded theory was used in this qualitative study. SETTING/SUBJECTS: Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29338743/the-prospective-and-concurrent-effect-of-exercise-on-health-related-quality-of-life-in-older-adults-over-a-3%C3%A2-year-period
#2
Helen-Maria Vasiliadis, Mathieu F Bélanger
BACKGROUND: It is not clear whether socioeconomic status influences health outcomes among older adults through its effect on physical activity. The aim of this study was to assess the effect of sex and neighborhood socio-economic status on the change in health related quality of life (HR-QOL) as a function of physical activity over a three-year period. METHODS: This cohort study included French-speaking community-dwelling older adults recruited in primary care practices in the province of Quebec and participating in the 'Étude sur la Santé des Ainés' (ESA)-Services study on the health of the elderly...
January 16, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29337041/provision-of-abortion-and-other-reproductive-health-services-among-former-midwest-access-project-trainees
#3
Debra B Stulberg, Kristie Monast, Irma H Dahlquist, Kate Palmer
OBJECTIVE: The Midwest Access Project (MAP) offers opt-in training to students, residents, and practicing clinicians in reproductive healthcare including abortion. We surveyed MAP alumni to identify current practice characteristics and assess predictors of reproductive health service provision. STUDY DESIGN: We sent an online survey to alumni of MAP's Individual Clinical Training program, 2007-2015 (n=127). The primary outcome was current provision of any abortion service...
January 11, 2018: Contraception
https://www.readbyqxmd.com/read/29336168/dementia-in-eastern-mediterranean-countries-a-systematic-review
#4
Sara Mahmoud Yaghmour, Ruth Bartlett, Tula Brannelly
Globally, there is an increase in the older population, whose lives are affected by local cultural norms. In Eastern Mediterranean countries, dementia is conventionally hidden from view with few dedicated services or recognition for diagnosis. The aim of this systematic review is to explore the limited literature on dementia and cognitive impairment among older people in Eastern Mediterranean countries to present an evaluation of current practices and to consolidate knowledge for future planning. Thirty-three studies were identified for inclusion in the review, and four themes were apparent...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29333106/which-point-of-care-tests-would-be-most-beneficial-to-add-to-clinical-practice-findings-from-a-survey-of-3-family-medicine-clinics-in-the-united-states
#5
Victoria Hardy, William Alto, Gina A Keppel, Laura-Mae Baldwin, Matthew Thompson
Background: Point-of-care tests (POCTs) are increasingly used in family medicine to facilitate screening, diagnosis, monitoring, treatment, and referral decisions for a variety of conditions. Point-of-care tests that clinicians believe might be beneficial to add to clinical practice and the conditions for which they would be most useful in family medicine remain poorly understood in the United States. Methods: Forty-two clinicians at 3 family medicine residency clinics completed a brief survey asking which POCTs they believed would be beneficial to add to their clinical practice and the conditions POCTs would be most useful for...
December 2017: Point of Care
https://www.readbyqxmd.com/read/29330247/frequency-and-criticality-of-diagnoses-in-family-medicine-practices-from-the-national-ambulatory-medical-care-survey-namcs
#6
Michael R Peabody, Thomas R O'Neill, Keith L Stelter, James C Puffer
BACKGROUND: Family medicine is a specialty of breadth, providing comprehensive health care for the individual and the family that integrates the broad scope of clinical, social, and behavioral sciences. As such, the scope of practice (SOP) for family medicine is extensive; however, over time many family physicians narrow their SOP. We sought to provide a nationally representative description of the most common and the most critical diagnoses that family physicians see in their practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#7
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#8
Amelia Sattler, Tracy Rydel, Cathina Nguyen, Steven Lin
PURPOSE: The immense clerical burden felt by physicians is one of the leading causes of burnout. Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. METHODS: Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#9
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/29319376/the-effect-of-physical-activity-on-ptsd
#10
Lauren M Oppizzi, Reba Umberger
Although physical activity (PA) is known to reduce anxiety and depression, less is known about the effects of PA on post-traumatic stress disorder (PTSD). The author examined the state of the science regarding the effect of PA on PTSD. Three themes emerged: PA characteristics, added benefits of PA as a PTSD intervention, and theories on the method of action. Physical activity seems to be an effective adjunct therapy to reduce PTSD symptom severity. Findings are inconsistent between observational and controlled studies...
January 10, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29311177/medical-students-views-of-medicine-as-a-calling-and-selection-of-a-primary-care-related-residency
#11
Audiey C Kao, Andrew J Jager
With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the "practice of medicine is a calling." Students who strongly agreed that medicine was a calling had higher odds (P=.003) of selecting a primary care-related residency...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29310735/what-do-clinical-supervisors-require-to-teach-residents-in-family-medicine-how-to-care-for-seniors
#12
Anik M C Giguere, Paule Lebel, Michèle Morin, Françoise Proust, Charo Rodríguez, Valerie Carnovale, Louise Champagne, France Légaré, Pierre-Hugues Carmichael, Bernard Martineau, Philippe Karazivan, Pierre J Durand
We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations...
January 9, 2018: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/29302597/ethical-challenges-involved-in-obtaining-consent-for-research-from-patients-hospitalized-in-the-intensive-care-unit
#13
Fiona Ecarnot, Jean-Pierre Quenot, Guillaume Besch, Gaël Piton
Clinical research remains a vital contributor to medical knowledge, and is an established and integral part of the practice of medicine worldwide. Respect for patient autonomy and ethical principles dictate that informed consent must be obtained from subjects before they can be enrolled into clinical research, yet these conditions may be difficult to apply in real practice in the intensive care unit (ICU). A number of factors serve to complexify the consent process in critically ill patients, notably decisional incapacity of the patient due to illness or sedation...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29302511/need-of-department-of-general-practice-family-medicine-at-aiims-all-india-institute-of-medical-sciences-why-the-apex-medical-institute-in-india-should-also-contribute-towards-training-and-education-of-general-practitioners-and-family-physicians
#14
EDITORIAL
Ranabir Pal, Raman Kumar
Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29290201/a-definition-of-family-medicine-and-general-practice
#15
M Jawad Hashim
Definitions of general practice and family medicine have tended to be difficult to understand. We propose a new definition that is brief and clear. General practice / family medicine is defined as the medical specialty that manages common and long-term illnesses in children and adults, focusing on overall health and well-being. The definition should be followed by local examples of diseases within the scope of primary care such as asthma, diabetes as well as end-of-life care. This definition is based on the concept of common illnesses, reflecting the reality that family physicians manage most health conditions in a community...
January 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29285763/gp-practices-as-a-one-stop-shop-how-do-patients-perceive-the-quality-of-care-a-cross-sectional-study-in-thirty-four-countries
#16
Willemijn L A Schäfer, Wienke G W Boerma, François G Schellevis, Peter P Groenewegen
OBJECTIVE: To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. STUDY SETTING: Between 2011 and 2013, primary care data were collected among GPs and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GPs are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting...
December 29, 2017: Health Services Research
https://www.readbyqxmd.com/read/29283621/-joy-in-practice-requires-workforce-well-being
#17
Christine N Runyan
In this column, the president of the Collaborative Family Healthcare Association notes that the national conversation about physician burnout has recently shifted to discussing the importance of finding joy in practice. However, she is concerned the current culture of medicine, hidden curricula in medical training, a draconian financial system, and an emotionally ill-prepared workforce may preclude sustained joy in practice. Formal curricula do not include resiliency skills, mindfulness, cognitive flexibility and reframing, conflict-resolution skills, emotional-regulation skills, or how to practice empathy and compassion without crumbling from vicarious trauma...
December 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29279731/acupuncture-associated-vasovagal-response-revised-terminology-and-hospital-experience
#18
Kimberly A Christensen, Barbara J Gosse, Celia Hildebrand, Lynn A Gershan
Background: Vasovagal responses associated with acupuncture therapy are relatively uncommon adverse events, occurring in ∼0.02%-7% of treatments. The complex neurocardiovascular reflexes involved in vasovagal responses can induce a range of symptoms such as dizziness, nausea, sweating, bradycardia, hypotension, and, in some cases, syncope or convulsions. Although patients typically recover quickly with proper support, these events may be of concern and anxiety-producing for both patient and provider. Providers need to be well-versed in methods for prevention and treatment of acupuncture-associated vasovagal responses to promote safe practice environments, patient satisfaction and comfort, and cost-effectiveness...
December 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/29278544/self-management-strategies-in-chronic-obstructive-pulmonary-disease-a-first-step-toward-personalized-medicine
#19
Miriam Barrecheguren, Jean Bourbeau
PURPOSE OF REVIEW: Self-management has gained increased relevance in the management of chronic obstructive pulmonary disease patients. The heterogeneity in self-management interventions has complicated the development of recommendations for clinical practice. In this review, we present the latest findings regarding conceptual definition, effectiveness of self-management interventions and self-management strategies in chronic obstructive pulmonary disease as a first step toward personalized medicine: what, how and to whom? RECENT FINDINGS: Self-management interventions have shown benefits in improving health-related quality of life and reducing hospital admissions...
December 22, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29277629/patterns-and-correlates-of-cervical-cancer-screening-initiation-in-a-large-integrated-healthcare-system
#20
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2...
December 22, 2017: American Journal of Obstetrics and Gynecology
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