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https://www.readbyqxmd.com/read/28323547/the-extent-that-health-professionals-suspect-and-address-addiction-to-medicines-in-primary-care-findings-from-a-survey-in-northwest-england
#1
Geoff Bates, Madeleine Cochrane, Adam John Mackridge
Addiction to medicines available over the counter or via prescription is of growing international concern. The authors of the current article ran an online survey of health professionals in general medical practice and community pharmacy settings in Northwest England to explore the frequency of suspecting and responding to addiction to medicines. Health professionals reported frequently identifying addiction to medicines among patients including those with long-term pain, mental health problems, sleep disorders, and other substance use disorders, but that these addictions often go unchallenged...
March 1, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28317473/the-columbia-bronx-va-amalgamative-clerkship-an-effective-12-week-integrated-longitudinal-clinical-experience
#2
Jillian Diuguid-Gerber, Samuel Porter, Samuel C Quiah, Katherine Nickerson, Deborah Jones, Zeena Audi, Boyd F Richards
BACKGROUND: Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. OBJECTIVE: In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC)...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28315478/improving-palliative-care-trough-teamwork-impactt-in-nursing-homes-study-design-and-baseline-findings
#3
Helena Temkin-Greener, Susan Ladwig, Zhiqiu Ye, Sally A Norton, Dana B Mukamel
BACKGROUND: The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life...
March 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28315116/evaluating-the-prevalence-of-potentially-inappropriate-prescribing-in-older-adults-in-intermediate-care-facilities-a-cross-sectional-observational-study
#4
Anna Millar, Carmel Hughes, Cristín Ryan
Background Potentially inappropriate prescribing (PIP) [encompassing potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs)], is prevalent amongst older adults in primary and secondary care. However, PIP prevalence in intermediate care (IC) is unknown. Objective To determine the prevalence of PIMs/PPOs and associated patient factors. Setting Three IC facilities in Northern Ireland. Method The Screening Tool of Older People's Prescriptions and the Screening Tool to Alert doctors to Right Treatment were used to identify PIP over 8 weeks...
March 17, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28314432/-consensus-document-on-the-management-and-follow-up-of-the-male-with-lower-urinary-tract-symptoms-secondary-to-benign-prostate-hyperplasia
#5
F J Brenes Bermúdez, F Brotons Muntó, J Castiñeiras Fernández, J M Cozar Olmo, A Fernández-Pro Ledesma, J A Martín Jiménez, M L Martínez-Berganza Asensio, B Miñana López, J M Molero García
Benign prostate hyperplasia (BPH) is a high-incidence condition. Its diagnosis and treatment is shared between urologists and Primary Care physicians. Its management uses up a significant amount of resources. The Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of General Practitioners and Family Doctors (SEMG), the Spanish Society of Family and Community Medicine (semFYC), and the Spanish Association of Urology (AEU) have prepared a document on the management and monitoring of BPH, in which the aim is to incorporate the latest evidence in order to update the previously published guidelines, and present them here in condensed form...
November 2016: Semergen
https://www.readbyqxmd.com/read/28306323/a-feasibility-assessment-of-behavioral-based-interviewing-to-improve-candidate-selection-for-a-pulmonary-and-critical-care-medicine-fellowship-program
#6
Geneva Tatem, Maria Kokas, Cathy L Smith, Bruno DiGiovine
Traditional interviews for residency and fellowship training programs are an important component in the selection process, but can be of variable value due to a non-standardized approach. We redesigned the candidate interview process for our large pulmonary and critical care medicine fellowship program in the United States using a behavioral-based interview structure. The primary goal of this approach was to standardize the assessment of candidates within non-cognitive domains with the goal of selecting those with the best fit for our institution's fellowship program...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28304182/insurance-reimbursement-for-complementary-healthcare-services
#7
James Whedon, Tor D Tosteson, Anupama Kizhakkeveettil, Melissa Nagare Kimura
INTRODUCTION: Insurance reimbursement for clinical services provided by complementary healthcare professionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financially accessible to all who may need or want these services. The purpose of this project was to evaluate the likelihood of insurance reimbursement for complementary healthcare services compared with other complementary services and with conventional primary care medical services in New Hampshire...
March 17, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28302636/pharmacist-provided-medicines-reconciliation-within-24%C3%A2-hours-of-admission-and-on-discharge-a-randomised-controlled-pilot-study
#8
Brit Cadman, David Wright, Amanda Bale, Garry Barton, James Desborough, Eman A Hammad, Richard Holland, Helen Howe, Ian Nunney, Lisa Irvine
BACKGROUND: The UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist-delivered service was undertaken. METHOD: Patients were recruited 7 days a week from 5 adult medical wards in 1 hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28301962/overcoming-obesity
#9
Elaine Seaton Banerjee, Sharon J Herring, Katelyn E Hurley, Katherine Puskarz, Kyle Yebernetsky, Marianna LaNoue
PURPOSE: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). DESIGN: Mixed methods, positive deviance study. SETTING: Urban university-based family medicine practice. PARTICIPANTS: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months...
January 1, 2017: American Journal of Health Promotion: AJHP
https://www.readbyqxmd.com/read/28301892/evaluating-the-performance-of-ultrasound-screening-for-congenital-heart-disease-a-descriptive-cohort-study
#10
Rosemary J Froehlich, Lindsay Maggio, Phinnara Has, Erika F Werner, Dwight J Rouse
Objective The objective of this study was to evaluate the rate of abnormal fetal echocardiogram after normal detailed anatomy ultrasound when both are performed by maternal-fetal medicine specialists. Study Design Retrospective review of women who underwent detailed anatomy ultrasound and fetal echocardiography between 16 and 26 weeks' gestation at a single center. Women included had at least one indication for fetal echocardiography as recommended by the American Institute of Ultrasound in Medicine and normal cardiac anatomy on initial detailed anatomy ultrasound...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28300988/-mental-health-in-general-family-medicine-obstacles-and-expectations-perceived-by-family-physicians
#11
Liliana Fernandes, Nuno Basílio, Sofia Figueira, José Mendes Nunes
This study seeks to understand the difficulties experienced by family physicians (FP) in the management of mental disorders (MD) and their proposals to improve the quality of care. It is qualitative study with semi-structured interviews with ten family physicians. These were recorded, transcribed and their content analyzed. Eight thematic categories were identified: perceived working conditions and available resources; perceived level of training in mental health; therapies used for treatment of MD; mental health instruments used in consultation; MD addressed in Primary Health Care (PHC) and referral to hospitals; patient's reaction to referral; articulation of PHC with hospitals; proposals to improve mental health care in PHC...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300986/primary-health-care-quality-in-rocinha-rio-de-janeiro-brazil-from-the-perspective-of-children-caregivers-and-adult-users
#12
Luiz Felipe Pinto, Erno Harzheim, Lisiane Hauser, Otávio Pereira D'Avila, Marcelo Rodrigues Gonçalves, Paula Travassos, Renan Pessanha
This paper aims to evaluate the extent of PHC attributes, from the experience of users, both adults and children caregivers, comparing the area served by the health facilities of the district of Rocinha with other areas of health district 2.1 in the municipality of Rio de Janeiro. The measuring tool used to evaluate the quality of services provided was the Primary Care Assessment Tools. A cross-sectional study was conducted, with independent random samples and 802 interviewees. Results indicate a better performance for children care when compared to adult care...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300983/preceptorship-in-family-and-community-medicine-challenges-and-achievements-in-a-primary-health-care-in-progress
#13
Mellina Marques Vieira Izecksohn, Jorge Esteves Teixeira, Bruno Pereira Stelet, Adelson Guaraci Jantsch
Strengthening Primary Health Care (PHC) relies directly on training medical specialists in primary care. This text aims to report the Family Medicine training experiences in Rio de Janeiro between 2008 and 2016. It brings to reflection the development of preceptors in medical specialization through an experience report on three Family Medicine medical residency programs, namely, the Municipal Health Secretariat program, the Federal University of Rio de Janeiro program and the National School of Public Health program...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28299031/continuity-of-care-evaluation-the-view-of-patients-and-professionals-about-urban-family-physician-program
#14
Vahid Kohpeima Jahromi, Mohammad Hossein Mehrolhassani, Reza Dehnavieh, Hosein Saberi Anari
BACKGROUND: A responsibility of the family physician (FP) and one of the four aspects of the delivery of primary care services is continuity of care (COC). This study aimed to determine the COC of health care in urban health centers. METHODS: Between September 2015 and March 2016, we conducted a cross-sectional study using Primary Care Evaluation Tool questionnaires with multistage stratified cluster sample of FPs (n = 141) and patients (n = 710) in two provinces in Iran, Fars and Mazandaran...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28298226/addressing-the-double-burden-of-diabetes-and-tuberculosis-lessons-from-kyrgyzstan
#15
Jolene Skordis-Worrall, Jeff Round, Matthias Arnold, Aida Abdraimova, Baktygul Akkazieva, David Beran
BACKGROUND: The incidence of diabetes and tuberculosis co-morbidity is rising, yet little work has been done to understand potential implications for health systems, healthcare providers and individuals. Kyrgyzstan is a priority country for tuberculosis control and has a 5% prevalence of diabetes in adults, with many health system challenges for both conditions. METHODS: Patient exit interviews collected data on demographic and socio-economic characteristics, health spending and care seeking for people with diabetes, tuberculosis and both diabetes and tuberculosis...
March 15, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28297569/administration-of-adult-human-bone-marrow-derived-cultured-pooled-allogeneic-mesenchymal-stromal-cells-in-critical-limb-ischemia-due-to-buerger-s-disease-phase-ii-study-report-suggests-clinical-efficacy
#16
Pawan K Gupta, Murali Krishna, Anoop Chullikana, Sanjay Desai, Rajkumar Murugesan, Santanu Dutta, Uday Sarkar, Radhakrishnan Raju, Anita Dhar, Rajiv Parakh, Lakshmanan Jeyaseelan, Pachaiyappan Viswanathan, Prasanth Kulapurathu Vellotare, Raviraja N Seetharam, Charan Thej, Mathiyazhagan Rengasamy, Sudha Balasubramanian, Anish S Majumdar
Critical limb ischemia (CLI) due to Buerger's disease is a major unmet medical need with a high incidence of morbidity. This phase II, prospective, nonrandomized, open-label, multicentric, dose-ranging study was conducted to assess the efficacy and safety of i.m. injection of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (BMMSC) in CLI due to Buerger's disease. Patients were allocated to three groups: 1 and 2 million cells/kg body weight (36 patients each) and standard of care (SOC) (18 patients)...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28293671/pilot-phase-evaluation-of-the-elective-general-practice-class-results-of-student-surveys-of-the-first-two-years
#17
Franziska-Antonia Samos, Marcus Heise, Stephan Fuchs, Susanne Mittmann, Alexander Bauer, Andreas Klement
Background: Primary health care in rural regions is currently undergoing a global crisis in respect of the next generation of practitioners. National and international recommendations advise placing greater emphasis upon practical skills and competences in medical studies. It is also in the interest of training the next generation to include mentoring and longitudinal integration of contact to teaching practices for general medicine in an early stage. Consequently, the General Practice Class (KAM) was introduced in Halle in 2011 as an elective with 20 individually mentored students per year, beginning with the first subject-related semester...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28292486/the-impact-of-china-s-national-essential-medicine-policy-and-its-implications-for-urban-outpatients-a-multivariate-difference-in-differences-study
#18
Liman Ding, Jing Wu
OBJECTIVES: To evaluate the effects of the National Essential Medicine Policy (NEMP) on outpatient service utilization and expenditure in Tianjin, China. METHODS: All government-owned general primary health care centers (PHCs) within the Urban Employee Basic Medical Insurance in Tianjin were involved in the study. Of these, 49 PHCs implemented the NEMP in April 2009, and constituted the intervention group, and the remaining PHCs constituted the control group. Patients who had visited only one of the two groups at least once pre-NEMP (April 2008 to March 2009) and post-NEMP (April 2009 to March 2010) were included in the correspondent group...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#19
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28292257/medical-appropriateness-of-adult-calls-to-danish-out-of-hours-primary-care-a-questionnaire-based-survey
#20
Karen Busk Nørøxe, Linda Huibers, Grete Moth, Peter Vedsted
BACKGROUND: Optimal utilisation of the out-of-hours primary care (OOH-PC) services remains a concern in public health policy. We need more knowledge on potentially avoidable contacts. This study examines the frequency of medically assessed inappropriate OOH-PC calls from adults, explores factors associated with such assessment, and examines the relation to patient-assessed severity of health problem and fulfilment of expectations. METHODS: We performed secondary analyses of data from a large cross-sectional survey on contacts to Danish OOH-PC...
March 14, 2017: BMC Family Practice
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