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https://www.readbyqxmd.com/read/28301962/overcoming-obesity
#1
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/28289123/treatment-of-hypertension-in-adults-over-age-60-to-higher-vs-lower-targets-a-clinical-practice-guideline-from-the-american-college-of-physicians-and-the-american-academy-of-family-physicians
#2
Amir Qaseem, Timothy J Wilt, Robert Rich, Linda Humphrey, Jennifer Frost, Mary Ann Forciea
No abstract text is available yet for this article.
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28289113/the-effects-of-training-institution-practice-costs-quality-and-other-characteristics-on-future-practice
#3
Robert L Phillips, Stephen M Petterson, Andrew W Bazemore, Peter Wingrove, James C Puffer
PURPOSE: Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated. METHODS: We conducted a secondary, multi-level, multivariable analysis of 2011 Medicare claims and American Medical Association Masterfile data for a random, nationally representative sample of family physicians and general internists who completed residency between 1992 and 2010 and had more than 40 Medicare patients (3,075 physicians providing care to 503,109 beneficiaries)...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28286136/is-a-positive-developmental-behavioral-screening-score-sufficient-to-justify-referral-a-review-of-evidence-and-theory
#4
R Christopher Sheldrick, Daryl Garfinkel
In their recommendations on screening for autism and developmental disabilities, the American Academy of Pediatrics recommends referral subsequent to a positive screening result. In this paper, we argue that positive screening results are not always sufficient to justify a referral. We demonstrate that while positive predictive values are often low, they actually overstate the probability of having a disorder for many children who screen positive. Moreover, recommended screening thresholds are seldom set to ensure that the benefits of referral will equal or exceed the costs and risk of harm, which is a necessary condition for an optimal threshold in the field of decision analysis...
March 7, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28284397/optimizing-the-diagnosis-and-management-of-dravet-syndrome-recommendations-from-a-north-american-consensus-panel
#5
Elaine C Wirrell, Linda Laux, Elizabeth Donner, Nathalie Jette, Kelly Knupp, Mary Anne Meskis, Ian Miller, Joseph Sullivan, Michelle Welborn, Anne T Berg
OBJECTIVES: To establish standards for early, cost-effective, and accurate diagnosis; optimal therapies for seizures; and recommendations for evaluation and management of comorbidities for children and adults with Dravet syndrome, using a modified Delphi process. METHODS: An expert panel was convened comprising epileptologists with nationally recognized expertise in Dravet syndrome and parents of children with Dravet syndrome, whose experience and understanding was enhanced by their active roles in Dravet syndrome associations...
March 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28277021/the-chinese-and-korean-american-immigrant-experience-a-mixed-methods-examination-of-facilitators-and-barriers-of-colorectal-cancer-screening
#6
Mary Y Jung, Cheryl L Holt, Diane Ng, Hwa J Sim, Xiaoxiao Lu, Daisy Le, Hee-Soon Juon, Jun Li, Sunmin Lee
OBJECTIVE: Among Asian Americans, colorectal cancer (CRC) is the second leading cause of cancer deaths. Despite strong evidence that screening can reduce CRC-related mortality, fewer Chinese and Koreans receive screening as compared to non-Hispanic whites and blacks. The objective of this study was to examine facilitators and barriers as well as strategies to promote CRC screening in this population. DESIGN: This study employed a mixed-methods design. We conducted 17 key informant interviews and 12 focus groups in the Washington, D...
February 25, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28209292/cholesterol-screening-and-treatment-practices-and-preferences-a-survey-of-united-states-pediatricians
#7
Sarah D de Ferranti, Angie Mae Rodday, Susan K Parsons, William L Cull, Karen G O'Connor, Stephen R Daniels, Laurel K Leslie
OBJECTIVES: To determine pediatricians' practices, attitudes, and barriers regarding screening for and treatment of pediatric dyslipidemias in 9- to 11-year-olds and 17- to 21-year-olds. STUDY DESIGN: American Academy of Pediatrics (AAP) 2013-2014 Periodic Survey of a national, randomly selected sample of 1627 practicing AAP physicians. Pediatricians' responses were described and modeled. RESULTS: Of 614 (38%) respondents who met eligibility criteria, less than half (46%) were moderately/very knowledgeable about the 2008 AAP cholesterol statement; fewer were well-informed about 2011 National Heart, Lung, and Blood Institute Guidelines or 2007 US Preventive Service Task Force review (both 26%)...
February 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28182607/advisory-committee-on-immunization-practices-recommended-immunization-schedule-for-children-and-adolescents-aged-18-years-or-younger-united-states-2017
#8
Candice L Robinson, José R Romero, Allison Kempe, Cynthia Pellegrini
In October 2016, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger-United States, 2017. The 2017 child and adolescent immunization schedule summarizes ACIP recommendations, including several changes from the 2016 immunization schedules, in three figures, and footnotes for the figures. These documents can be found on the CDC immunization schedule website (https://www.cdc.gov/vaccines/schedules/index.html)...
February 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28182599/advisory-committee-on-immunization-practices-recommended-immunization-schedule-for-adults-aged-19-years-or-older-united-states-2017
#9
David K Kim, Laura E Riley, Kathleen H Harriman, Paul Hunter, Carolyn B Bridges
In October 2016, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Adults Aged 19 Years or Older-United States, 2017. The 2017 adult immunization schedule summarizes ACIP recommendations in two figures, footnotes for the figures, and a table of contraindications and precautions for vaccines recommended for adults. These documents are available at https://www.cdc.gov/vaccines/schedules. The full ACIP recommendations for each vaccine can be found at https://www...
February 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28169869/low-density-lipoprotein-receptor-mutational-analysis-in-diagnosis-of-familial-hypercholesterolemia
#10
Mafalda Bourbon, Ana C Alves, Eric J Sijbrands
PURPOSE OF REVIEW: To present up to date evidence on the pathogenicity of low-density lipoprotein receptor (LDLR) variants and to propose a strategy that is suitable for implementation in the clinical work-up of familial hypercholesterolaemia. RECENT FINDINGS: More than 1800 variants have been described in the LDLR gene of patients with a clinical diagnosis of familial hypercholesterolaemia; however, less than 15% have functional evidence of pathogenicity. SUMMARY: The spectrum of variants in the LDLR identified in patients with clinical familial hypercholesterolaemia is increasing as novel variants are still being reported...
February 6, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28167517/the-need-to-optimize-adolescent-immunization
#11
Henry H Bernstein, Joseph A Bocchini
The adolescent period heralds the pediatric patient's transition into adulthood. It is a time of dynamic development during which effective preventive care measures can promote safe behaviors and the development of lifelong health habits. One of the foundations of preventive adolescent health care is timely vaccination, and every visit can be viewed as an opportunity to update and complete an adolescent's immunizations.In the past decade, the adolescent immunization schedule has expanded to include 2 doses of quadrivalent meningococcal conjugate vaccine, 1 dose of tetanus, diphtheria, acellular pertussis, absorbed vaccine, 2 or 3 doses of human papillomavirus vaccine, depending on the child's age, and an annual influenza vaccine...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28167515/practical-approaches-to-optimize-adolescent-immunization
#12
Henry H Bernstein, Joseph A Bocchini
With the expansion of the adolescent immunization schedule during the past decade, immunization rates notably vary by vaccine and by state. Addressing barriers to improving adolescent vaccination rates is a priority. Every visit can be viewed as an opportunity to update and complete an adolescent's immunizations. It is essential to continue to focus and refine the appropriate techniques in approaching the adolescent patient and parent in the office setting. Health care providers must continuously strive to educate their patients and develop skills that can help parents and adolescents overcome vaccine hesitancy...
February 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/28164409/emergency-physician-knowledge-attitudes-and-behavior-regarding-acep-s-choosing-wisely-recommendations-a-survey-study
#13
Michelle P Lin, Thomas Nguyen, Marc A Probst, Lynne D Richardson, Jeremiah D Schuur
OBJECTIVE: In 2013, the American College of Emergency Physicians joined the Choosing Wisely campaign; however, its impact on emergency physician behavior is unknown. We assessed knowledge, attitudes and self-reported behaviors regarding the Choosing Wisely recommendations. METHODS: We performed a cross-sectional survey of emergency physicians at a national meeting. We approached 819 physicians; 765 (93.4%) completed the survey. RESULTS: As a result of the Choosing Wisely campaign, most respondents (64...
February 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28152847/lung-cancer-screening-knowledge-and-beliefs-among-primary-care-providers-and-pulmonologists
#14
Mikael Anne Greenwood-Hickman, Laura Jones, M Patricia Rivera, J Michael Bowling, Paul Molina, Susan Maygarden, Katherine Birchard, Dan Reuland, Louise Henderson
191 Background: In response to the National Lung Screening Trial's findings, numerous professional organizations have published guidelines recommending annual lung cancer (LC) screening with low dose computed tomography (LDCT) for eligible patients. In the wake of these guidelines, we sought to assess LC screening practices and beliefs among providers at a large academic medical center. METHODS: In 2015, we surveyed 54 physicians and 9 residents in pulmonology (27% response rate) and 86 physicians and 100 residents in family/internal medicine (39% response rate)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152747/connecting-specialty-practices-with-primary-care
#15
Suzanne Morton, Tyler Oberlander, Sarah Hudson Scholle, Michael Barr
47 Background: Public and private payers are beginning to adopt alternative payment structures that call for greater attention to patient-centered care and quality improvement activities (CMMI 2015; MACRA 2015). The National Committee for Quality Assurance (NCQA) developed standards for Patient-Centered Specialty Practice based on American College of Physicians principles. The report describes achievement on the standards among an initial cohort of recognized physicians. METHODS: We analyzed practice characteristics and determined how practices performed on each of the 21 elements in the PCSP program by showing the percent of practices scoring less than 50% of points, or 100% of points (i...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151787/critical-care-nurses-perceptions-of-end-of-life-care-obstacles-comparative-17-year-data
#16
Renea L Beckstrand, Nicole Lamoreaux, Karlen E Luthy, Janelle L B Macintosh
BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end of life (EOL). Providing high-quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made for the last 17 years. OBJECTIVE: The aims of this study were to determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether meaningful changes have occurred since data were first gathered in 1998...
March 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28140456/discussing-molecular-testing-in-oncology-care-comparing-patient-and-physician-information-preferences
#17
Ana P M Pinheiro, Rachel H Pocock, Jeffrey M Switchenko, Margie D Dixon, Walid L Shaib, Suresh S Ramalingam, Rebecca D Pentz
BACKGROUND: Molecular testing to inform treatment and clinical trial choices is now the standard of care for several types of cancer. However, no established guidelines exist for the type of information physicians should cover during discussions with the patient about the test or its results. The objectives of this study were to identify physician and patient preferences regarding information and who should communicate this information and how to inform guidelines for these conversations...
January 31, 2017: Cancer
https://www.readbyqxmd.com/read/28135725/pharmacologic-treatment-of-hypertension-in-adults-aged-60-years-or-older-to-higher-versus-lower-blood-pressure-targets-a-clinical-practice-guideline-from-the-american-college-of-physicians-and-the-american-academy-of-family-physicians
#18
Amir Qaseem, Timothy J Wilt, Robert Rich, Linda L Humphrey, Jennifer Frost, Mary Ann Forciea
Description: The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older. Methods: This guideline is based on a systematic review of published randomized, controlled trials for primary outcomes and observational studies for harms only (identified through EMBASE, the Cochrane Database of Systematic Reviews, MEDLINE, and ClinicalTrials...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28135186/physician-office-visits-for-attention-deficit-hyperactivity-disorder-in-children-and-adolescents-aged-4-17-years-united-states-2012-2013
#19
Micheal Albert, Pinyao Rui, Jill J Ashman
Data from the National Ambulatory Medical Care Survey •During 2012-2013, an estimated annual average of 6.1 million physician office visits were made by children aged 4-17 years with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). •The ADHD visit rate among children aged 4-17 years was more than twice as high for boys (147 per 1,000 boys) as for girls (62 per 1,000 girls). •Central nervous system stimulant medications were provided, prescribed, or continued at about 80% of ADHD visits among children aged 4-17 years...
January 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/28121896/public-perception-of-cosmetic-surgeons-versus-plastic-surgeons-increasing-transparency-to-educate-patients
#20
Ajul Shah, Anup Patel, John Smetona, Rod J Rohrich
BACKGROUND: The American Society of Plastic Surgeons' "Do Your Homework" campaign strives to educate the public on how to identify providers who can safely perform aesthetic/cosmetic/plastic surgery. Although the campaign continues to heighten awareness, misperceptions remain in determining who these providers are. This study aims to examine whether the general public is confused by the titles "plastic surgeon" or "cosmetic surgeon," and accordingly, evaluates whether misperceptions need to be remedied to have an informed and safe patient...
February 2017: Plastic and Reconstructive Surgery
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