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https://www.readbyqxmd.com/read/28101828/current-trends-in-the-diagnosis-and-management-of-syndesmotic-injury
#1
REVIEW
Matthew L Vopat, Bryan G Vopat, Bart Lubberts, Christopher W DiGiovanni
Ideal management of the various presentations of syndesmotic injury remains controversial to this day. High quality evidentiary science on this topic is rare, and numerous existing studies continue to contradict one another. The primary reasons for these discrepancies are that previous studies have failed to (1) properly distinguish between isolated (non-fractured) and non-isolated injuries, (2) accurately define stable from unstable injuries, and (3) sufficiently differentiate between acute and chronic injuries...
January 18, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28100560/prevalence-impact-and-cost-of-multimorbidity-in-a-cohort-of-people-with-chronic-pain-in-ireland-a-study-protocol
#2
Brian W Slattery, Laura O'Connor, Stephanie Haugh, Christopher P Dwyer, Siobhan O'Higgins, Line Caes, Jonathan Egan, Brian E McGuire
INTRODUCTION: Multimorbidity (MM) refers to the coexistence of two or more chronic conditions within one person, where no one condition is considered primary. As populations age and healthcare provision improves, MM is becoming increasingly common and poses a challenge to the single morbidity approach to illness management, usually adopted by healthcare systems. Indeed, recent research has shown that 66.2% of the people in primary care in Ireland are living with MM. Healthcare usage and cost is significantly associated with MM, and additional chronic conditions lead to exponential increases in service usage and financial costs, and decreases in physical and mental well-being...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28099522/anodal-transcranial-direct-current-stimulation-shows-minimal-measure-specific-effects-on-dynamic-postural-control-in-young-and-older-adults-a-double-blind-sham-controlled-study
#3
Chesney E Craig, Michail Doumas
We investigated whether stimulating the cerebellum and primary motor cortex (M1) using transcranial direct current stimulation (tDCS) could affect postural control in young and older adults. tDCS was employed using a double-blind, sham-controlled design, in which young (aged 18-35) and older adults (aged 65+) were assessed over three sessions, one for each stimulatory condition-M1, cerebellar and sham. The effect of tDCS on postural control was assessed using a sway-referencing paradigm, which induced platform rotations in proportion to the participant's body sway, thus assessing sensory reweighting processes...
2017: PloS One
https://www.readbyqxmd.com/read/28097630/re-engagement-into-care-the-role-of-social-support-on-service-use-for-recurrent-episodes-of-mental-health-distress-among-primary-care-patients
#4
Marissa C Hansen, Dahlia Fuentes, Maria P Aranda
Given high rates of relapse of depression, understanding mechanisms that provide long-term benefits and optimal outcomes for depressed individuals is crucial. The current study examines social support as a relevant component in service use to manage mental health needs for individuals with recurrent depression over a 5-year period. Conducting a secondary data analysis from a randomized clinical trial titled Partners in Care, the study examines direct and moderating effects over two time points of reported 12-month social support on service use for mental health needs at 57-months for an adult sample (n = 991)...
January 17, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28096740/unanswered-clinical-questions-a-survey-of-specialists-and-primary-care-providers
#5
Ellen Brassil, Bridget Gunn, Anant M Shenoy, Rebecca Blanchard
OBJECTIVE: With the myriad of cases presented to clinicians every day at our integrated academic health system, clinical questions are bound to arise. Clinicians need to recognize these knowledge gaps and act on them. However, for many reasons, clinicians might not seek answers to these questions. Our goal was to investigate the rationale and process behind these unanswered clinical questions. Subsequently, we explored the use of biomedical information resources among specialists and primary care providers and identified ways to promote more informed clinical decision making...
January 2017: Journal of the Medical Library Association: JMLA
https://www.readbyqxmd.com/read/28096666/barriers-and-facilitators-influencing-self-management-among-copd-patients-a-mixed-methods-exploration-in-primary-and-affiliated-specialist-care
#6
Chantal F Hillebregt, Auke J Vlonk, Marc A Bruijnzeels, Onno Cp van Schayck, Niels H Chavannes
Self-management is becoming increasingly important in COPD health care although it remains difficult to embed self-management into routine clinical care. The implementation of self-management is understood as a complex interaction at the level of patient, health care provider (HCP), and health system. Nonetheless there is still a poor understanding of the barriers and effective facilitators. Comprehension of these determinants can have significant implications in optimizing self-management implementation and give further directions for the development of self-management interventions...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28096238/activation-of-trpa1-channel-by-antibacterial-agent-triclosan-induces-vegf-secretion-in-human-prostate-cancer-stromal-cells
#7
Sandra Derouiche, Pascal Mariot, Marine Warnier, Eric Vancauwenberghe, Gabriel Bidaux, Pierre Gosset, Brigitte Mauroy, Jean-Louis Bonnal, Christian Slomianny, Philippe Delcourt, Etienne Dewailly, Natalia Prevarskaya, Morad Roudbaraki
Accruing evidence indicates that exposure to environmental compounds may adversely impact human health and promote carcinogenesis. Triclosan (TCS), an antimicrobial agent widely used as a preservative in personal care products, has been shown to act as an endocrine disruptor in hormone-dependent tissues. Here we demonstrate a new molecular mechanism by which TCS stimulates the secretion by human prostate cancer stromal cells of Vascular Endothelial Growth Factor (VEGF), a factor known to promote tumour growth...
January 17, 2017: Cancer Prevention Research
https://www.readbyqxmd.com/read/28095824/community-based-health-care-is-an-essential-component-of-a-resilient-health-system-evidence-from-ebola-outbreak-in-liberia
#8
Kendra Siekmans, Salim Sohani, Tamba Boima, Florence Koffa, Luay Basil, Saïd Laaziz
BACKGROUND: Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. METHODS: A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff...
January 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28095335/guilt-shame-and-expressed-emotion-in-carers-of-people-with-long-term-mental-health-difficulties-a-systematic-review
#9
Mary Gemma Cherry, Peter James Taylor, Stephen Lloyd Brown, Jake Wilfred Rigby, William Sellwood
Expressed emotion (EE) is a global index of familial emotional climate, whose primary components are emotional over-involvement (EOI) and critical comments (CC)/hostility. There is a strong theoretical rationale for hypothesising that carers' guilt and shame may be differentially associated with their EOI and CC/hostility respectively. This systematic review investigates the magnitude of these theorised associations in carers of people with long-term mental health difficulties. Electronic searches (conducted in May 2016 across Medline, CINAHL, Embase, PsycINFO and ProQuest) were supplemented with iterative hand searches...
January 5, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28095068/impact-of-telepharmacy-services-as-a-way-to-increase-access-to-asthma-care
#10
Wendy Brown, David Scott, Daniel Friesner, Tara Schmitz
OBJECTIVE: To demonstrate that real-time, telepharmacy-based asthma educational services are feasible and support the efforts of local primary care prescribers to improve patient outcomes. METHODS: The lead investigator [a pharmacist, physician assistant and certified asthma educator] identified an independent community pharmacy with telehealth capabilities in a rural area with a high prevalence of asthma. Working with the pharmacy, an asthma education program was developed based on the National Asthma Education and Prevention Program guidelines...
January 17, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#11
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28093423/medical-and-psychosocial-factors-associated-with-antibiotic-prescribing-in-primary-care-survey-questionnaire-and-factor-analysis
#12
Tau-Hong Lee, Joshua Gx Wong, David Cb Lye, Mark Ic Chen, Victor Wk Loh, Yee-Sin Leo, Linda K Lee, Angela Lp Chow
BACKGROUND: Acute upper respiratory infections (AURI) are the leading causes of antibiotic prescribing in primary care although antibiotics are often not indicated. AIM: To gain an understanding of the knowledge, attitudes, and practices (KAP) of GPs in Singapore and the associated latent factors to guide the implementation of an effective programme to reduce antibiotic use in primary care. DESIGN AND SETTING: An anonymous survey on the KAP of antibiotic use in AURI of GPs in Singapore...
January 16, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#13
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28088871/herbal-medicine-practices-of-patients-with-liver-cancer-in-peru
#14
Teresa Rojas Rojas, Geneviève Bourdy, Eloy Ruiz, Juan-Pablo Cerapio, Pascal Pineau, Jacques Gardon, Franco Doimi, Xavier Deparis, Eric Deharo, Stéphane Bertani
RATIONALE: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru. STUDY DESIGN AND METHODS: A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru...
December 1, 2016: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/28088552/antipredator-tactics-are-largely-maternally-controlled-in-goitered-gazelle-a-hider-ungulate
#15
David Blank
Predation is usually the primary cause of infant death among ungulate species, with the annual variation in the survival of neonates over their first summer a major factor in the population dynamics of many ungulates. Consequently, the maternal rearing strategy of a species is crucial for its reproductive success. Since the roles mothers and fawns play in the implementation of antipredator strategies in hider species have been poorly understood until now, this paper considers this behavior in the goitered gazelle, which is a typical hider species...
January 11, 2017: Behavioural Processes
https://www.readbyqxmd.com/read/28086753/better-care-provided-to-patients-with-tuberculosis-at-county-designated-tb-hospitals-ctd-compared-to-non-ctds-in-rural-china
#16
Li Yuan, Hui Zhang, Changming Zhou, Weili Jiang, Qi Zhao, Xu Biao
BACKGROUND: The primary unit of tuberculosis (TB) medical care in China is the county TB dispensary or county designated hospital (CTD), where patients can receive free diagnosis and treatment. However, a substantial number of patients seek their anti-TB treatment from general health facilities (Non-CTDs). This study aimed to investigate the first anti-TB treatment experience and choice of health facilities of retreated TB patients and their determinants. METHODS: A cross-sectional study was conducted in Jiangsu, Shandong and Sichuan provinces...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28076549/training-of-pharmacy-technicians-for-dispensing-drugs-in-primary-health-care
#17
Daniela Oliveira de Melo, Caroline Godoi Rezende da Costa Molino, Eliane Ribeiro, Nicolina Silvana Romano-Lieber
Few Brazilian articles discuss the importance of pharmacy technicians who offer direct assistance to patients. This paper describes an experience of the training of pharmacy technicians in drug dispensing. A descriptive, cross-sectional study was conducted in the primary healthcare setting. The technicians were trained by the pharmacist to advise patients at the time of drug dispensing and to screen cases that needed pharmaceutical consultation. Problems were identified by verifying the prescription and return date for dispensing the medication as well as through direct questioning of the patients...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28075696/dual-eligibles-experience-of-care-with-north-carolina-s-patient-centered-medical-home
#18
Sarah Grantham, Debora Goetz Goldberg, Donna Lind Infeld
Although individuals enrolled in both Medicare and Medicaid (dual eligibles) are among those with the nation's greatest need, at $300 billion per year, their care is also expensive and beset by quality problems. Previous research found problems associated with inadequate coordination of benefits and services; however, these studies have largely used quantitative approaches and focused on providers-few studies have explored the perspective of dual eligible patients. In an effort to improve care and reduce costs, North Carolina (NC) developed a Patient-Centered Medical Home (PCMH) model centered on a continuous relationship with a primary care provider who is responsible for coordination of services and addressing patients' health care needs by providing direct services or arranging care with other qualified professionals...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28074980/-implications-of-chilean-legal-framework-in-teen-pregnancy-prevention-conflict-and-insecurity-in-health-professionals
#19
Carolina Luttges D, Carolina Leyton M, Ingrid Leal F, Paulina Troncoso E, Temístocles Molina G
BACKGROUND: Teenage pregnancy is a psychosocial and multifactorial problem described as a lack of exercise of rights in sexual and reproductive health. There are important aspects in the doctor-patient relationship and confidentiality that directly affect the continuity and quality of care. There are controversies in the laws relating to the provision of contraception and confidentiality, and those that protect the sexual indemnity, especially in adolescents under 14 years. AIM: To describe the implications of the legal framework for professional midwives in the care of adolescents younger than 14 years in sexual and reproductive health...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28074421/community-based-accompaniment-with-supervised-antiretrovirals-for-hiv-positive-adults-in-peru-a-cluster-randomized-trial
#20
Megan M McLaughlin, Molly F Franke, Maribel Muñoz, Adrianne K Nelson, Olga Saldaña, Janeth Santa Cruz, Milagros Wong, Zibiao Zhang, Leonid Lecca, Eduardo Ticona, Jorge Arevalo, Eduardo Sanchez, Jose Luis Sebastián, Sonya Shin
We conducted a cluster-randomized trial to estimate effects of directly observed combination antiretroviral therapy (DOT-cART) on retention with viral suppression among HIV-positive adults in Peru. We randomly allocated facilities to receive the 12-month intervention plus the standard of care, including adherence support provided through accompaniment. In the intervention arm, health workers supervised doses, twice daily, and accompanied patients to appointments. Among 356 patients, intention-to-treat analyses showed no statistically significant benefit of DOT, relative to no-DOT, at 12 or 24 months (adjusted probability of primary outcome: 0...
January 10, 2017: AIDS and Behavior
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