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Consultation models

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https://www.readbyqxmd.com/read/28088420/exploring-expert-opinion-on-the-practicality-and-effectiveness-of-biosecurity-measures-on-dairy-farms-in-the-united-kingdom-using-choice-modeling
#1
Orla Shortall, Martin Green, Marnie Brennan, Wendela Wapenaar, Jasmeet Kaler
Biosecurity, defined as a series of measures aiming to stop disease-causing agents entering or leaving an area where farm animals are present, is very important for the continuing economic viability of the United Kingdom dairy sector, and for animal welfare. This study gathered expert opinion from farmers, veterinarians, consultants, academics, and government and industry representatives on the practicality and effectiveness of different biosecurity measures on dairy farms. The study used best-worst scaling, a technique that allows for greater discrimination between choices and avoids the variability in interpretation associated with other methods, such as Likert scales and ranking methods...
January 11, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28081292/the-utility-of-abbreviated-patient-reported-outcomes-for-predicting-survival-in-early-stage-colorectal-cancer
#2
Tina Hsu, Caroline H Speers, Hagen F Kennecke, Winson Y Cheung
BACKGROUND: Patient-reported outcomes (PROs) are increasingly used in clinical settings. Prior research suggests that PROs collected at baseline may be associated with cancer survival, but most of those studies were conducted in patients with breast or lung cancer. The objective of this study was to determine the correlation between prospectively collected PROs and cancer-specific outcomes in patients with early stage colorectal cancer. METHODS: Patients who had newly diagnosed stage II or III colorectal cancer from 2009 to 2010 and had a consultation at the British Columbia Cancer Agency completed the brief Psychosocial Screen for Cancer (PSSCAN) questionnaire, which collects data on patients' perceived social supports, quality of life (QOL), anxiety and depression, and general health...
January 12, 2017: Cancer
https://www.readbyqxmd.com/read/28078508/prioritization-of-liver-mri-for-distinguishing-focal-lesions
#3
Qinghua Su, Shusheng Bi, Xuedong Yang
Liver cancer is one of the leading causes of cancer-related mortality worldwide. Magnetic resonance imaging (MRI) is a non-invasive imaging technique that is often used by radiologists for diagnosis and surgical planning. Analysis of a large amount of liver MRI data for each patient limits the radiologist's efficiency and may lead to misdiagnoses. The redundant MRI data, especially from dynamic contrast enhanced (DCE) sequences, is also a bottleneck in transmitting the images via the internet or PACS for remote consultancy in a reasonable amount of time...
January 4, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28074587/after-the-dnr-surrogates-who-persist-in-requesting-cardiopulmonary-resuscitation
#4
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28069041/understanding-how-primary-care-practitioners-perceive-an-online-intervention-for-the-management-of-hypertension
#5
Katherine Bradbury, Katherine Morton, Rebecca Band, Carl May, Richard McManus, Paul Little, Lucy Yardley
BACKGROUND: In order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP). METHODS: Our Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures...
January 9, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28068983/a-comparison-of-two-psychiatric-service-approaches-findings-from-the-consultation-vs-liaison-psychiatry-study
#6
Caroline Lücke, Jürgen M Gschossmann, Alena Schmidt, Juliane Gschossmann, Alexandra Philomena Lam, Charlotte Elizabeth Schneider, Alexandra Philipsen, Helge H Müller
BACKGROUND: Psychiatric comorbidities are common in somatically ill patients. There is a lack of data that can provide clear insights into substantial comparative advantages of different Consultation/Liaison Psychiatry (CLP) services. METHODS: The Consultation versus Liaison Psychiatry-Study collected and analyzed data of 890 primarily somatically ill hospital inpatients presenting with psychiatric symptoms in a prospective observational study design. One group was treated via a liaison-model (LM) with regular consultation hours, the other via an on-demand-model (ODM) with individually requested consultations...
January 10, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28068386/influenza-vaccine-effectiveness-in-the-netherlands-from-2003-2004-through-2013-2014-the-importance-of-circulating-influenza-virus-types-and-subtypes
#7
Maryam Darvishian, Frederika Dijkstra, Eva van Doorn, Maarten J Bijlsma, Gé A Donker, Marit M A de Lange, Laura M Cadenau, Eelko Hak, Adam Meijer
Influenza vaccine effectiveness (IVE) varies over different influenza seasons and virus (sub)types/lineages. To assess the association between IVE and circulating influenza virus (sub)types/lineages, we estimated the overall and (sub)type specific IVE in the Netherlands. We conducted a test-negative case control study among subjects with influenza-like illness or acute respiratory tract infection consulting the Sentinel Practices over 11 influenza seasons (2003/2004 through 2013/2014) in the Netherlands. The adjusted IVE was estimated using generalized linear mixed modelling and multiple logistic regression...
2017: PloS One
https://www.readbyqxmd.com/read/28062335/productivity-in-pediatric-palliative-care-measuring-and-monitoring-an-elusive-metric
#8
Erica C Kaye, Zachary R Abramson, Jennifer M Snaman, Sarah E Friebert, Justin N Baker
CONTEXT: Workforce productivity is poorly defined in healthcare. Particularly in the field of pediatric palliative care (PPC), the absence of consensus metrics impedes aggregation and analysis of data to track workforce efficiency and effectiveness. Lack of uniformly measured data also compromises the development of innovative strategies to improve productivity and hinders investigation of the link between productivity and quality of care, which are interrelated but not interchangeable...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28061535/perioperative-goal-setting-consultations-by-surgical-colleagues-a-new-model-for-supporting-patients-families-and-surgeons-in-shared-decision-making
#9
Ana Berlin, Anastasia Kunac, Anne C Mosenthal
Patients with postoperative complications are often subjected to prolonged life-sustaining treatment based on erroneous assumptions about their goals of care. Shared decision making (SDM) is an evidence-based approach that helps ensure patients' wishes and values are honored in their course of treatment. Perioperative palliative care can help create goal-concordant trajectories of care for high risk, seriously ill, or complicated patients, through sophisticated prognostication, higher-level communication, and recommendations based on the best available evidence and patients' stated goals and priorities...
November 29, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28059000/the-effects-of-preoperative-cardiology-consultation-prior-to-elective-abdominal-aortic-aneurysm-repair-on-patient-morbidity
#10
Anna E Boniakowski, Frank M Davis, Amanda R Phillips, Adina B Robinson, Dawn M Coleman, Peter K Henke
Objectives The relationship between preoperative medical consultations and postoperative complications has not been extensively studied. Thus, we investigated the impact of preoperative consultation on postoperative morbidity following elective abdominal aortic aneurysm repair. Methods A retrospective review was conducted on 469 patients (mean age 72 years, 20% female) who underwent elective abdominal aortic aneurysm repair from June 2007 to July 2014. Data elements included detailed medical history, preoperative cardiology consultation, and postoperative complications...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28057875/perceived-challenges-of-working-in-a-fertility-clinic-a-qualitative-analysis-of-work-stressors-and-difficulties-working-with-patients
#11
Jacky Boivin, Laura Bunting, Emily Koert, Chin Ieng U, Christianne Verhaak
STUDY QUESTION: What are some of the challenges of working in a fertility clinic? SUMMARY ANSWER: The most frequently mentioned challenges were workload (e.g. high time pressure) and patient-related sources (e.g. unrealistic expectations). WHAT IS KNOWN ALREADY: One study showed a too high workload, worry about handling human material and low success rates were main stressors in fertility clinics. STUDY DESIGN, SIZE, DURATION: An online open-ended survey inviting participants to respond to seven questions was distributed to 5902 members of the European Society for Human Reproduction and Embryology (ESHRE, October 2010)...
January 5, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28057511/principles-and-strategies-for-improving-the-prevention-of-cardio-metabolic-diseases-in-indigenous-populations-an-international-delphi-study
#12
Lee Stoner, Anna G Matheson, Lane G Perry, Michelle A Williams, Alexandra McManus, Maureen Holdaway, Lyn Dimer, Jennie R Joe, Andrew Maiorana
The disparity in life expectancy between Indigenous and non-Indigenous populations, including within high-income countries, is driven by a heightened risk of cardio-metabolic diseases. The current study recruited independent panels of experts in Indigenous cardio-metabolic health from Australia, New Zealand and the United States, in order to establish local consensus opinion and initiate dialogue on appropriate prevention strategies. Therefore, a three-round Delphi process was used to consolidate and compare the opinions of 60 experts, 20 from each country...
January 2, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28057447/antidepressant-prescribing-by-pediatricians-a-mixed-methods-analysis
#13
Anne K Tulisiak, Jillian A Klein, Emily Harris, Marissa J Luft, Heidi K Schroeder, Sarah A Mossman, Sara T Varney, Brooks R Keeshin, Sian Cotton, Jeffrey R Strawn
Among pediatricians, perceived knowledge of efficacy, tolerability, dosing, and side effects of antidepressants represent significant sources of variability in the use of these medications in youth with depressive and anxiety disorders. Importantly, the qualitative factors that relate to varying levels of comfort with antidepressants and willingness to prescribe are poorly understood. Using a mixed-methods approach, in-depth interviews were conducted with community-based and academic medical center-based pediatricians (N = 14)...
January 2, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28057060/u-shaped-association-between-untreated-caries-and-body-mass-index-in-adults-at-rabat-dental-university-hospital-morocco-cross-sectional-study
#14
Sanaa Chala, Manal El Aidouni, Redouane Abouqal, Faïza Abdallaoui
BACKGROUND: Many previous studies estimating the relationship between body mass index (BMI) and dental decay are conflicting. Most studies, however, examine the relationship using BMI as a categorical variable. This study evaluated the non-linear association between body mass index as a continuous variable and untreated dental decay. METHODS: Cross-sectional study of adults free of diseases attending a tertiary dental clinic was conducted. The number of untreated caries at the time of consultation was assessed using the WHO criteria...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28056974/an-evaluation-of-the-telehealth-facilitation-of-diabetes-and-cardiovascular-care-in-remote-australian-indigenous-communities-protocol-for-the-telehealth-eye-and-associated-medical-services-network-teamsnet-project-a-pre-post-study-design
#15
Laima Brazionis, Alicia Jenkins, Anthony Keech, Chris Ryan, Sven-Erik Bursell
BACKGROUND: Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia...
January 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28056665/the-patient-perspective-on-the-effects-of-medical-record-accessibility-a-systematic-review
#16
Peter Vermeir, Sophie Degroote, Dominique Vandijck, Hanne Van Tiggelen, Renaat Peleman, Rik Verhaeghe, An Mariman, Dirk Vogelaers
BACKGROUND: Health care is shifting from a paternalistic to a participatory model, with increasing patient involvement. Medical record accessibility to patients may contribute significantly to patient comanagement. OBJECTIVES: To systematically review the literature on the patient perspective of effects of personal medical record accessibility on the individual patient, patient-physician relationship and quality of medical care. METHODS: Screening of PubMed, Web of Science, Cinahl, and Cochrane Library on the keywords 'medical record', 'patient record', 'communication', 'patient participation', 'doctor-patient relationship', 'physician-patient relationship' between 1 January 2002 and 31 January 2016; systematic review after assessment for methodological quality...
January 6, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28056101/improving-access-to-mental-health-care-by-delivering-psychotherapeutic-care-in-the-workplace-a-cross-sectional-exploratory-trial
#17
Eva Rothermund, Reinhold Kilian, Edit Rottler, Dorothea Mayer, Michael Hölzer, Monika A Rieger, Harald Gündel
OBJECTIVE: Common mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care) improves access to treatment for common mental disorders. METHODS: Conditional latent profile analysis was applied to identify user profiles for work ability (WAI), clinical symptoms like depression (patient health questionnaire depression, PHQ-9), health-related quality of life (QoL, SF-12), and work-related stress (Maslach Burnout Inventory, irritation scale)...
2017: PloS One
https://www.readbyqxmd.com/read/28054447/comparison-of-hospital-outcomes-and-resource-use-in-acute-copd-exacerbation-patients-managed-by-teaching-versus-nonteaching-services-in-a-community-hospital
#18
Khalid Abusaada, Leen Alsaleh, Victor Herrera, Yuan Du, Hassan Baig, George Everett
RATIONALE, AIMS, AND OBJECTIVES: The impact of teaching versus nonteaching services on outcomes and resource use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown. The aim of the study is to evaluate the impact of an internal medicine teaching service compared to a nonteaching service on outcomes and resource use in patients admitted with AECOPD in a community teaching hospital. METHODS: A retrospective cohort study of patients admitted for a primary diagnosis of chronic obstructive pulmonary disease exacerbation to Florida Hospital Orlando, a large community teaching hospital, between January 1, 2011, and December 31, 2014...
January 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28054237/what-is-the-future-for-general-surgery-in-model-3-hospitals
#19
K Mealy, F Keane, P Kelly, G Kelliher
BACKGROUND: General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland. AIM: The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning. METHODS: General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset. Current consultant staffing was ascertained from hospital personnel departments and all trainees on the National Surgical Training Programme were asked to complete a questionnaire on their career intentions...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28052316/training-interventions-for-improving-telephone-consultation-skills-in-clinicians
#20
REVIEW
Alberto Vaona, Yannis Pappas, Rumant S Grewal, Mubasshir Ajaz, Azeem Majeed, Josip Car
BACKGROUND: Since 1879, the year of the first documented medical telephone consultation, the ability to consult by telephone has become an integral part of modern patient-centred healthcare systems. Nowadays, upwards of a quarter of all care consultations are conducted by telephone. Studies have quantified the impact of medical telephone consultation on clinicians' workload and detected the need for quality improvement. While doctors routinely receive training in communication and consultation skills, this does not necessarily include the specificities of telephone communication and consultation...
January 5, 2017: Cochrane Database of Systematic Reviews
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