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https://www.readbyqxmd.com/read/29351604/evaluation-of-results-based-financing-in-the-republic-of-the-congo-a-comparison-group-pre-post-study
#1
Wu Zeng, Donald S Shepard, Jean de Dieu Rusatira, Aaron P Blaakman, Bernice M Nsitou
Results-based financing (RBF) has been advocated and increasingly scaled up in low- and middle-income countries to increase utilization and quality of key primary care services, thereby reducing maternal and child mortality rates. This pilot RBF study in the Republic of the Congo from 2012 to 2014 used a quasi-experimental research design. The authors conducted pre- and post-household surveys and gathered health facility services data from both intervention and comparison groups. Using a difference-in-differences approach, the study evaluated the impact of RBF on maternal and child health services...
January 16, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29346701/identifying-prevalence-and-characteristics-of-behavioral-health-education-in-family-medicine-clerkships-a-cera-study
#2
Mario P DeMarco, Renée M Betancourt, Kelly M Everard, Kent D W Bream
BACKGROUND AND OBJECTIVES: Many patients with behavioral health disorders do not seek or receive adequate care for their conditions. Among those that do, most will receive care in a primary care setting. To best meet this need, clinicians will need to demonstrate proficiency of behavioral health skills and evidence-based practices. We sought to explore the degree to which these skills are being taught in family medicine clerkships. METHODS: The Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) 2016 survey of clerkship directors (CDs) was sent to 141 CDs at US and Canadian medical schools with a required family medicine run course...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#3
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/29346307/knowledge-and-attitudes-of-general-practitioners-and-sexual-health-care-professionals-regarding-human-papillomavirus-vaccination-for-young-men-who-have-sex-with-men
#4
Samuel W D Merriel, Carrie Flannagan, Joanna M Kesten, Gilla K Shapiro, Tom Nadarzynski, Gillian Prue
Men who have sex with men (MSM) may be at higher risk for human papillomavirus (HPV)-associated cancers. Healthcare professionals' recommendations can affect HPV vaccination uptake. Since 2016, MSM up to 45 years have been offered HPV vaccination at genitourinary medicine (GUM) clinics in a pilot programme, and primary care was recommended as a setting for opportunistic vaccination. Vaccination prior to potential exposure to the virus (i.e., sexual debut) is likely to be most efficacious, therefore a focus on young MSM (YMSM) is important...
January 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29345622/position-paper-on-nasal-obstruction-evaluation-and-treatment
#5
REVIEW
A Valero, A M Navarro, A Del Cuvillo, I Alobid, J R Benito, C Colás, G de Los Santos, R Fernández Liesa, A García-Lliberós, R González-Pérez, A Izquierdo-Domínguez, A Jurado-Ramos, M M Lluch-Bernal, J R Montserrat Gili, J Mullol, A Puiggròs Casas, M C Sánchez-Hernández, F Vega, J M Villacampa, M Armengot-Carceller, M T Dordal
Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care, and it may affect up to 30-40% of the population. It affects the quality of life (it especially disturbs sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment...
January 18, 2018: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/29345100/relationship-between-orthodox-and-traditional-medical-practitioners-in-the-transmission-of-traditional-medical-knowledge-in-nigeria
#6
Janet O Adekannbi
BACKGROUND: The problem of incomplete transmission of traditional medical knowledge to the younger generation is of concern to information professionals especially in developing countries where most rural communities depend on traditional medicine for primary health care. OBJECTIVE: The purpose of this study was to investigate the collaboration between orthodox and traditional medical practitioners as well as the implication of the collaboration for transmission of traditional medical knowledge in Nigeria...
January 18, 2018: Health Information and Libraries Journal
https://www.readbyqxmd.com/read/29344003/a-medical-student-in-private-practice-for-a-1-month-clerkship-a-qualitative-exploration-of-the-challenges-for-primary-care-clinical-teachers
#7
Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat
Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Methods: Data were collected via a focus group using a semistructured interview guide...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#8
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29341162/impact-of-genomics-on-the-surgical-management-of-melanoma
#9
REVIEW
P M Ferguson, G V Long, R A Scolyer, J F Thompson
BACKGROUND: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341157/minimizing-inequality-in-access-to-precision-medicine-in-breast-cancer-by-real-time-population-based-molecular-analysis-in-the-scan-b-initiative
#10
L Rydén, N Loman, C Larsson, C Hegardt, J Vallon-Christersson, M Malmberg, H Lindman, A Ehinger, L H Saal, Å Borg
BACKGROUND: Selection of systemic therapy for primary breast cancer is currently based on clinical biomarkers along with stage. Novel genomic tests are continuously being introduced as more precise tools for guidance of therapy, although they are often developed for specific patient subgroups. The Sweden Cancerome Analysis Network - Breast (SCAN-B) initiative aims to include all patients with breast cancer for tumour genomic analysis, and to deliver molecular subtype and mutational data back to the treating physician...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29339109/bitter-gourd-reduces-elevated-fasting-plasma-glucose-levels-in-an-intervention-study-among-prediabetics-in-tanzania
#11
Michael B Krawinkel, Christine Ludwig, Mark E Swai, Ray-Yu Yang, Kwok Pan Chun, Sandra D Habicht
ETHNOPHARMACOLOGICAL RELEVANCE: Impaired glucose tolerance and diabetes mellitus have become major health issues even in non-industrialized countries. As access to clinical management is often poor, dietary interventions and alternative medicines are required. For bitter gourd, Momordica charantia L., antidiabetic properties have been claimed. AIM OF THE STUDY: The main objective of the intervention study was to assess antidiabetic effects of daily bitter gourd consumption of 2...
January 12, 2018: Journal of Ethnopharmacology
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
#12
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/29338539/primary-care-provider-experience-with-breast-density-legislation-in-massachusetts
#13
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/29338278/the-effects-of-interprofessional-diabetes-education-on-the-knowledge-of-medical-dentistry-and-nursing-students
#14
Maja Račić, Bojan N Joksimović, Smiljka Cicmil, Srebrenka Kusmuk, Nedeljka Ivković, Natalija Hadživuković, Milan Kulić, Biljana Mijović, Mirjana Mirić, Vedrana R Joksimović, Milena Dubravac
OBJECTIVES: Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. METHODS: The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29337041/provision-of-abortion-and-other-reproductive-health-services-among-former-midwest-access-project-trainees
#15
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/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
#16
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/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#17
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/29330242/patient-perspectives-on-discussions-of-electronic-cigarettes-in-primary-care
#18
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/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#19
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
#20
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
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