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https://www.readbyqxmd.com/read/28821421/exploring-canadian-physicians-experiences-with-diabetes-care-for-indigenous-patients
#1
Lynden Lindsay Crowshoe, Rita I Henderson, Michael E Green, Kristen M Jacklin, Leah M Walker, Betty Calam
OBJECTIVES: The perspectives of physicians caring for Indigenous patients with diabetes offer important insights into the provision of health-care services. The purpose of this study was to describe Canadian physicians' perspectives on diabetes care of Indigenous patients, a preliminary step in developing a continuing medical education intervention described elsewhere. METHODS: Through in-depth semistructured interviews, Canadian family physicians and specialists with sizeable proportions of Indigenous clientele shared their experiences of working with Indigenous patients who have type 2 diabetes...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28812935/motivations-for-learning-of-family-medicine-residents-trained-in-competency-based-education
#2
Oksana Babenko, Olga Szafran, Sudha Koppula, Lillian Au
BACKGROUND AND OBJECTIVE: Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected to engage in on-going learning to respond to changing needs of family practice. Using Achievement Goal Theory, the objective of this study was to examine motivations for learning of family medicine residents in a competency-based program. METHOD: This was a cross-sectional study, employing a survey methodology with family medicine residents at the mid-point of training at a Canadian university...
August 16, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28795577/understanding-the-emergence-and-development-of-medical-collaboration-across-organizational-boundaries-a-longitudinal-case-study
#3
Nassera Touati, Charo Rodríguez, Marie-Andrée Paquette, Jean-Louis Denis
Our goal in this investigation was to help shed light on the very difficult process of collaboration between family physicians and specialists working at different levels of healthcare delivery. More precisely, and grounded on Giddens' structuration theory, our investigation aims to understand how medical collaboration emerges and develops around chronic patients. This was a longitudinal interpretive case study, the "case" being a continuum-of-care for patients suffering from diabetes, put in place in an urban health center in the Canadian province of Quebec...
August 1, 2017: Health (London)
https://www.readbyqxmd.com/read/28794620/spreading-improvements-for-advanced-copd-care-through-a-canadian-collaborative
#4
Graeme M Rocker, Claudia Amar, Wendy L Laframboise, Jane Burns, Jennifer Y Verma
BACKGROUND: A year-long pan-Canadian quality improvement collaborative (QIC) led by the Canadian Foundation for Healthcare Improvement (CFHI) supported the spread of the successful Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ to 19 teams in the 10 Canadian provinces. We describe QIC results, addressing two main questions: 1) Can the results of the Nova Scotia INSPIRED model be replicated elsewhere in Canada? 2) How did the teams implement and evaluate their versions of the INSPIRED program? METHODS: Collaborative faculty selected measures that were evidence-based, relatively simple to collect, and relevant to local context...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28789558/canadian-schizophrenia-guidelines-introduction-and-guideline-development-process
#5
Tamara Pringsheim, Donald Addington
INTRODUCTION: The aim of the Canadian Schizophrenia Guidelines is to provide evidence-based recommendations for the treatment of schizophrenia and schizophrenia spectrum disorders. The target users are health care professionals. Recommendations are provided as guidance to physicians and patients, with the goal of improving the overall standard of care of individuals with schizophrenia. METHODS: The guidelines were developed using the ADAPTE process, a systematic approach and alternative to de novo guideline development, in which an existing guideline is customised to suit the local context...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28743319/nationwide-survey-on-current-management-strategies-of-toddler-s-fractures
#6
Jade Seguin, Daniel Brody, Patricia Li
BACKGROUND: Tibial fractures are common in children less than 3 years old. The traditional management involves immobilization in an above knee cast for both confirmed (positive x-ray) and presumed (normal x-ray) toddler's fractures. This carries health care implications and causes unnecessary burden for patients and their families. There is a paucity of literature describing the ideal immobilization strategy for this injury. OBJECTIVES: To determine: 1) the variation between Canadian emergency departments in management of toddler's fractures; 2) the variation in management between confirmed and presumed toddler's fractures; 3) the association between demographic variables and immobilization strategies...
July 26, 2017: CJEM
https://www.readbyqxmd.com/read/28733056/uninsured-maternity-patients-in-calgary-local-trends-and-survey-of-health-care-workers
#7
Fiona M Mattatall
OBJECTIVE: Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/or citizenship for their newborn. This is the first Canadian study to quantify these patients and to review health care providers' perspectives and practices of care. METHODS: Data for all deliveries in Calgary, Alberta over a 4-year period (2013-2016) were analyzed...
July 18, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28701449/the-change-program-exercise-intervention-in-primary-care
#8
Doug Klein, Khursheed Jeejeebhoy, Angelo Tremblay, Matthew Kallio, Caroline Rheaume, Serena Humphries, Dawna Royall, Paula Brauer, Daren Heyland, Rupinder Dhaliwal, David M Mutch
PROBLEM ADDRESSED: Primary care settings require a feasible program for integrating lifestyle interventions, which can reverse metabolic abnormalities, for patients in practice. OBJECTIVE OF PROGRAM: To integrate a lifestyle intervention program into existing primary care clinics with an interprofessional approach that includes dietitians and kinesiologists. PROGRAM DESCRIPTION: Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) provides a personalized approach to nutrition and exercise modification focusing on patients with metabolic syndrome...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28697527/-family-health-teams-in-ontario-ideas-for-germany-from-a-canadian-primary-care-model
#9
Lisa-R Ulrich, Thuy-Nga Tia Pham, Ferdinand M Gerlach, Antje Erler
The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28606105/credentialing-and-retention-of-visa-trainees-in-post-graduate-medical-education-programs-in-canada
#10
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault, Lynda Buske
BACKGROUND: Visa trainees are international medical graduates (IMG) who come to Canada to train in a post-graduate medical education (PGME) program under a student or employment visa and are expected to return to their country of origin after training. We examined the credentialing and retention of visa trainees who entered PGME programs between 2005 and 2011. METHODS: Using the Canadian Post-MD Education Registry's National IMG Database linked to Scott's Medical Database, we examined four outcomes: (1) passing the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2), (2) obtaining a specialty designation (CCFP, FRCPC/SC), and (3) working in Canada after training and (4) in 2015...
June 12, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28578739/improving-team-based-care-for-children-shared-well-child-care-involving-family-practice-nurses
#11
Grace Warmels, Sharon Johnston, Jolanda Turley
INTRODUCTION: Well child care (WCC) is the provision of routine preventative care and vaccinations to infants and children. In Canada, physicians provide the majority of this type of care, whereas in other developed countries, nurses provide most WCC. New models of shared care between nurses and family physicians should be explored. OBJECTIVE: This pilot project aimed to evaluate the feasibility and acceptability of shared nurse-physician WCC for a cohort of healthy children...
June 5, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28500211/computer-use-in-primary-care-practices-in-canada
#12
Yvonne Anisimowicz, Andrea E Bowes, Ashley E Thompson, Baukje Miedema, William E Hogg, Sabrina T Wong, Alan Katz, Fred Burge, Kris Aubrey-Bassler, Gregory S Yelland, Walter P Wodchis
OBJECTIVE: To examine the use of computers in primary care practices. DESIGN: The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. SETTING: All 10 Canadian provinces...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28490923/multigene-expression-profile-testing-in-breast-cancer-is-there-a-role-for-family-physicians
#13
M A O'Brien, J C Carroll, D P Manca, B Miedema, P A Groome, T Makuwaza, J Easley, N Sopcak, L Jiang, K Decker, M L McBride, R Moineddin, J A Permaul, R Heisey, E A Eisenhauer, M K Krzyzanowska, S Pruthi, C Sawka, N Schneider, J Sussman, R Urquhart, C Versaevel, E Grunfeld
BACKGROUND: Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. METHODS: We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28490920/the-role-of-family-physicians-in-cancer-care-perspectives-of-primary-and-specialty-care-providers
#14
J Easley, B Miedema, M A O'Brien, J Carroll, D Manca, F Webster, E Grunfeld
BACKGROUND: Currently, the specific role of family physicians (fps) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of fps. METHODS: Using a constructivist grounded theory approach, we conducted telephone interviews with 58 primary and cancer specialist health care providers from across Canada. RESULTS: The participants-21 fps, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology-were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28483888/alignment-of-canadian-primary-care-with-the-patient-medical-home-model-a-qualico-pc-study
#15
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P Wodchis, Sabrina T Wong
PURPOSE: The patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model. METHODS: A cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#16
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28463015/effectiveness-of-group-cognitive-behavioral-therapy-for-insomnia-cbt-i-in-a-primary-care-setting
#17
Judith R Davidson, Samantha Dawson, Adrijana Krsmanovic
OBJECTIVE/BACKGROUND: Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. PARTICIPANTS: The patients were 70 women and 11 men (mean age = 57...
May 2, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28457296/the-role-of-occult-hypertension-in-retinal-vein-occlusions-and-diabetic-retinopathy
#18
Nataly Pesin, Efrem D Mandelcorn, Tina Felfeli, Richard I Ogilvie, Michael H Brent
OBJECTIVE: The aim of the study was to investigate whether individuals who develop retinal vein occlusion (RVO) or sudden-onset activity in otherwise quiescent diabetic retinopathy (DR) and those who have normal blood pressure (BP) or controlled hypertension according to their family physician show evidence of occult hypertension on 24-hour BP monitoring. METHODS: Patients with a new-onset RVO or DR that led to vitreous hemorrhage after a period of quiescence were identified...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#19
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#20
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
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