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https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#1
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29338539/primary-care-provider-experience-with-breast-density-legislation-in-massachusetts
#2
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/29337581/light-harvesting-by-equally-contributing-mechanisms-in-a-photosynthetic-antenna-protein
#3
Matthew J Guberman-Pfeffer, Jordan A Greco, Robert Richards Birge, Harry A Frank, José A Gascón
We report supramolecular quantum mechanics/molecular mechanics simulations on the peridinin-chlorophyll a protein (PCP) complex from the causative algal species of red tides. These calculations reproduce for the first time quantitatively the distinct peridinin absorptions, identify multichromophoric molecular excitations, and elucidate the mechanisms regulating the strongly-allowed S0 (11Ag-) → S2 (11Bu+) absorptions of the bound peridinins that span a 58 nm spectral range in the region of maximal solar irradiance...
January 16, 2018: Journal of Physical Chemistry Letters
https://www.readbyqxmd.com/read/29332213/survivorship-care-plan-outcomes-for-primary-care-physicians-cancer-survivors-and-systems-a-scoping-review
#4
REVIEW
Weston LaGrandeur, Julie Armin, Carol L Howe, Leila Ali-Akbarian
PURPOSE: With the focus on survivorship care-coordination between oncology and primary care providers (PCPs), there is a need to assess the research regarding the use of survivorship care plans (SCPs) and determine emerging research areas. We sought to find out how primary care physicians have been involved in the use of SCPs and determine SCP's effectiveness in improving care for cancer survivors. In this scoping review, we aimed to identify gaps in the current research and reveal opportunities for further research...
January 13, 2018: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29330243/task-delegation-and-burnout-trade-offs-among-primary-care-providers-and-nurses-in-veterans-affairs-patient-aligned-care-teams-va-pacts
#5
Samuel T Edwards, Christian D Helfrich, David Grembowski, Elizabeth Hulen, Walter L Clinton, Gordon B Wood, Linda Kim, Danielle E Rose, Greg Stewart
PURPOSE: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. METHODS: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330242/patient-perspectives-on-discussions-of-electronic-cigarettes-in-primary-care
#6
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
https://www.readbyqxmd.com/read/29330241/primary-care-physician-involvement-in-shared-decision-making-for-critically-ill-patients-and-family-satisfaction-with-care
#7
Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, David Y Hwang
PURPOSE: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. METHODS: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330240/structured-management-of-chronic-nonmalignant-pain-with-opioids-in-a-rural-primary-care-office
#8
Kevin S McCann, Shawndra Barker, Raymond Cousins, Adam Franks, Clinton McDaniel, Stephen Petrany, Eric Riley
INTRODUCTION: The use of opioid medication for nonmalignant chronic pain (NMCP) increased dramatically during the last 20 years. There have been regulatory changes implemented to reduce the risk of harm to both patients and society. Much of the burden of monitoring these patients is falling on primary care physicians (PCPs), who do not have the time or resources to handle what is entailed in a best-practice approach to NMCP. METHODS: A retrospective study was conducted with all patients on opioid medication for NMCP who were enrolled onto an individual PCP's practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29323050/long-non-coding-rna-nonmmug014387-promotes-schwann-cell-proliferation-after-peripheral-nerve-injury
#9
Bin Pan, Zhong-Ju Shi, Jia-Yin Yan, Jia-He Li, Shi-Qing Feng
Schwann cells play a critical role in peripheral nerve regeneration through dedifferentiation and proliferation. In a previous study, we performed microarray analysis of the sciatic nerve after injury. Accordingly, we predicted that long non-coding RNA NONMMUG014387 may promote Schwann cell proliferation after peripheral nerve injury, as bioinformatic analysis revealed that the target gene of NONMMUG014387 was collagen triple helix repeat containing 1 (Cthrc1). Cthrc1 may promote cell proliferation in a variety of cells by activating Wnt/PCP signaling...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29321069/gastroenterologist-and-primary-care-perspectives-on-a-post-endoscopy-discharge-policy-impact-on-clinic-wait-times-provider-satisfaction-and-provider-workload
#10
Daniel Selvig, Justin L Sewell, Delphine S Tuot, Lukejohn W Day
BACKGROUND: To reduce unnecessary ambulatory gastroenterology (GI) visits and increase access to GI care, San Francisco Health Network gastroenterologists and primary care providers implemented guidelines in 2013 that discharged certain patients back to primary care after endoscopy with formal written recommendations. This study assesses the longer-term impact of this policy on GI clinic access, workflow, and provider satisfaction. METHODS: An email-based survey assessed gastroenterologist and primary care provider (PCP) opinions about the discharge process...
January 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#11
Lillian Lai, Clare Liddy, Erin Keely, Amir Afkham, Julia Kurzawa, Nishard Abdeen, Tobey Audcent, Matthew Bromwich, Jason Brophy, Sasha Carsen, Annick Fournier, Leigh Fraser-Roberts, Hazen Gandy, Charles Hui, Donna Johnston, Kathryn Keely, Ken Kontio, Christine Lamontagne, Nathalie Major, Michael O'Connor, Dhenuka Radhakrishnan, Joe Reisman, Marjorie Robb, Lindy Samson, Erick Sell, William Splinter, Judy van Stralen, Sunita Venkateswaran, Kimmo Murto
BACKGROUND: Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. OBJECTIVE: To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults...
2018: PloS One
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#12
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29313552/effect-of-linear-and-non-linear-pseudohalides-on-the-structural-and-magnetic-properties-of-co-ii-hexacoordinate-single-molecule-magnets
#13
L Váhovská, S Vitushkina, I Potočňák, Z Trávníček, R Herchel
A series of mononuclear hexacoordinate Co(ii) complexes with the 4-amino-3,5-bis(2-pyridyl)-1,2,4-triazole (abpt) ligand and various linear and non-linear pseudohalides, such as NCSe (selenocyanate), N{C(CN)2}2 (1,1,3,3-tetracyano-2-azapropenide, tcap), NO2C(CN)2 (nitrodicyanomethanide, nodcm), C(CN){C(CN)2}2 (1,1,2,3,3-pentacyanopropenide, pcp), NO2NCN (nitrocyanamide, nca), and ONC(CN)2 (nitrosodicyanomethanide, ndcm), was prepared. X-ray analyses revealed the formation of the complexes with the general compositions [Co(abpt)2(solv)2]X2 (solv = H2O and X = tcap (1), solv = H2O and X = nodcm (2), solv = CH3OH and X = pcp (3)) or [Co(abpt)2(X)2] (X = nca (4), X = NCSe (5), X = ndcm (6))...
January 9, 2018: Dalton Transactions: An International Journal of Inorganic Chemistry
https://www.readbyqxmd.com/read/29303476/are-cancer-survivors-following-the-national-comprehensive-cancer-network-health-behavior-guidelines-an-assessment-of-patients-attending-a-cancer-survivorship-clinic
#14
Kelly A Hyland, Jamie M Jacobs, Inga T Lennes, William F Pirl, Elyse R Park
PURPOSE: Engaging in positive health behaviors post-treatment is important for cancer survivors' health. However, little is known about whether survivors are practicing health promoting behaviors. We aimed to explore whether survivors are meeting the recent health behavior guidelines set forth by the National Comprehensive Cancer Network (NCCN) and to examine associations between health behaviors and distress. METHODS: Sixty-six survivors completed a cross-sectional questionnaire assessing health behaviors prior to an initial appointment at a survivorship care clinic...
January 2018: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/29296031/dextromethorphan-in-cough-syrup-the-poor-man-s-psychosis
#15
Bridgette Martinak, Ramy A Bolis, Jeffrey Ryne Black, Rachel E Fargason, Badari Birur
Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia...
September 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/29289896/from-instruction-to-output-wnt-pcp-signaling-in-development-and-cancer
#16
REVIEW
Ashley Ceinwen Humphries, Marek Mlodzik
Planar cell polarity (PCP) provides positional information to direct tissue patterning and morphogenesis. While much of the molecular detail of the pathway has been delineated in Drosophila, ensuing studies have shown considerable conservation of both the components and mechanisms of signaling in vertebrates. A recognized feature of PCP is the asymmetric localization of components that translates a global directional cue into a polarized downstream output. Here we discuss recent advances in the PCP field, from the organization of these asymmetric complexes to their upstream directional regulation by Wnt ligands...
December 28, 2017: Current Opinion in Cell Biology
https://www.readbyqxmd.com/read/29289890/hydroxymethyl-bioisosteres-of-phenolic-glun2b-selective-nmda-receptor-antagonists-design-synthesis-and-pharmacological-evaluation
#17
Louisa Temme, Bastian Frehland, Dirk Schepmann, Dina Robaa, Wolfgang Sippl, Bernhard Wünsch
Antagonists addressing selectively NMDA receptors containing the GluN2B subunit are of particular interest for the treatment of various neurological disorders including neurodegenerative diseases. With the aim to bioisosterically replace the metabolically labile phenol of 7-amino-6,7,8,9-tetrahydro-5H-benzo[7]annulen-2-ols, several analogs were docked into the ifenprodil binding site leading to the hydroxymethyl derivatives 4 as promising candidates. They display the same binding pose as Ro 25-6981 and the same H-bond interactions with Gln110 and Glu236 within the GluN2B subunit...
December 18, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29288470/assessing-racial-disparities-in-hcv-infection-and-care-outcomes-in-a-southern-urban-population
#18
Keanan McGonigle, Tess Carley, Clarissa Hoff
OBJECTIVES: This study assessed racial disparities in access to healthcare services, hepatitis C virus (HCV) exposure, and retention in a treatment cascade in two indigent populations in an urban center in the Southern US. PARTICIPANTS/METHODS: Opt-in HCV antibody screening was offered at two large homeless centers and three residential substance abuse treatment centers (SATCs) in New Orleans, LA. Five hundred ninety-four participants experiencing homelessness and 342 residents of SATCs were assessed for previous access/perceived barriers to healthcare services and high-risk behaviors associated with HCV exposure...
December 29, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29286558/family-history-taking-practices-and-genetic-confidence-in-primary-and-tertiary-care-providers-for-childhood-cancer-survivors
#19
Claire E Wakefield, Veronica F Quinn, Joanna E Fardell, Christina Signorelli, Katherine M Tucker, Andrea F Patenaude, David Malkin, Thomas Walwyn, Frank Alvaro, Richard J Cohn
BACKGROUND: There is growing impetus for increased genetic screening in childhood cancer survivors. Family history-taking is a critical first step in determining survivors' suitability. However, the family history-taking practices of providers of pediatric oncology survivorship care and the confidence of these providers to discuss cancer risks to relatives are unknown. PROCEDURE: Fifty-four providers completed semistructured interviews in total, which included eight tertiary providers representing nine hospitals across two countries (63% male, 63% oncologists, 37% nurses) and 46 primary care providers (PCPs) nominated by a survivor (59% male, 35% regional practice)...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29284480/creating-research-and-development-awareness-among-dental-care-professionals-by-use-of-strategic-communication-a-12-year-intervention-study
#20
Helena Morténius, Svante Twetman
BACKGROUND: Despite the availability of contemporary research advances, only a limited fraction is implemented into dental practice. One possible way to facilitate this process is to stimulate the research and development (R&D) awareness and interest with aid of strategic communication. METHODS: The aim of the study was to analyse the role of a strategic communication in R&D awareness and interest among dental care professionals (DCP) over a 12-year period. A second aim was to compare the findings with those from primary care professionals (PCP)...
December 29, 2017: BMC Oral Health
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