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https://www.readbyqxmd.com/read/28335444/hiv-education-and-welfare-services-in-primary-care-an-empirical-model-of-integration-in-brazil-s-unified-health-system
#1
Rahbel Rahman, Rogério M Pinto, Melanie M Wall
Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#2
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28335000/better-than-sham-a-double-blind-placebo-controlled-neurofeedback-study-in-primary-insomnia
#3
Manuel Schabus, Hermann Griessenberger, Maria-Teresa Gnjezda, Dominik P J Heib, Malgorzata Wislowska, Kerstin Hoedlmoser
Neurofeedback training builds upon the simple concept of instrumental conditioning, i.e. behaviour that is rewarded is more likely to reoccur, an effect Thorndike referred to as the 'law of effect'. In the case of neurofeedback, information about specific electroencephalographic activity is fed back to the participant who is rewarded whenever the desired electroencephalography pattern is generated. If some kind of hyperarousal needs to be addressed, the neurofeedback community considers sensorimotor rhythm neurofeedback as the gold standard...
February 23, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#4
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334970/expenditure-tracking-and-review-of-reproductive-maternal-newborn-and-child-health-policy-in-pakistan
#5
Muhammad Ashar Malik, Abdul Sattar Nahyoun, Arjumand Rizvi, Zaid Ahmad Bhatti, Zulfiqar Ahmad Bhutta
Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals (MDGs) 4 and 5 were not achieved (2000-15). Maternal Mortality Ratio was reduced to 170 per 100 000 live births (target 100) by 2013 at an annual reduction rate of 3.6% (1990-2013). Against the target of 46 per 1000 live births, the Under Five Mortality Rate was reduced to 81 per 1000 live births by 2015 at an annual reduction rate of 2...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334936/satisfaction-with-general-practice-care-in-german-patients-with-multimorbidity-a-cross-sectional-study
#6
Achim Mortsiefer, Attila Altiner, Annette Ernst, Hanna Kadusziewicz, Alice Krahe, Christine Mellert, Ingmar Schäfer, Carl-Otto Stolzenbach, Birgitt Wiese, Christin Löffler
Background.: Little is known about the quality of general practice care received by patients suffering from multimorbidity. Objectives.: To assess how patients with multimorbidity evaluate their General Practitioners (GPs') performance and to identify factors associated with high patient satisfaction levels. Methods.: Cross-sectional study in Germany using the EUROPEP questionnaire consisting of 23 items with a five-point Likert scale and covering two dimensions: clinical performance of the GP and organisation of care...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334924/throat-swabs-in-children-with-respiratory-tract-infection-associations-with-clinical-presentation-and-potential-targets-for-point-of-care-testing
#7
Hannah V Thornton, Alastair D Hay, Niamh M Redmond, Sophie L Turnbull, Hannah Christensen, Tim J Peters, John P Leeming, Andrew Lovering, Barry Vipond, Peter Muir, Peter S Blair
Background and objectives.: Diagnostic uncertainty over respiratory tract infections (RTIs) in primary care contributes to over-prescribing of antibiotics and drives antibiotic resistance. If symptoms and signs predict respiratory tract microbiology, they could help clinicians target antibiotics to bacterial infection. This study aimed to determine relationships between symptoms and signs in children presenting to primary care and microbes from throat swabs. Methods.: Cross-sectional study of children ≥3 months to <16 years presenting with acute cough and RTI, with subset follow-up...
February 18, 2017: Family Practice
https://www.readbyqxmd.com/read/28334908/adherence-and-persistence-of-patients-using-oral-bone-sparing-drugs-in-primary-care
#8
Babette C van der Zwaard, Wesley van Hout, Jacqueline G Hugtenburg, Henriëtte E van der Horst, Petra J M Elders
Aim.: Studies based on pharmacy medication records have shown suboptimal adherence and persistence of osteoporosis treatment with oral bone sparing drugs (OBSD). Little is known about adherence and persistence of OBSD treatment in primary care. We assessed adherence and persistence of OBSD use of patients in general practices and identified associated factors. Methods.: Using electronic medical records, adherence and persistence of newly prescribed treatment with OBSD in patients from 16 general practices was retrospectively assessed...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#9
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334812/understanding-collaboration-in-general-practice-a-qualitative-study
#10
Susan McInnes, Kath Peters, Andrew Bonney, Elizabeth Halcomb
Background.: An increased incidence of chronic and complex conditions in the community is placing pressure on human resources in general practice. Improving collaboration between GPs and registered nurses may help alleviate workforce stressors and enhance health outcomes. Objective.: To explore the facilitators and challenges of collaboration between GPs and registered nurses in Australian general practice. Methods.: Eight GPs and 14 registered nurses from general practices in New South Wales, Australia, participated in semi-structured face-to-face interviews...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334801/a-systematic-review-of-the-physical-activity-assessment-tools-used-in-primary-care
#11
Toby O Smith, Máire C McKenna, Charlotte Salter, Wendy Hardeman, Kathryn Richardson, Melvyn Hillsdon, Carly A Hughes, Nicholas Steel, Andy P Jones
Background.: Primary care is an ideal setting for physical activity interventions to prevent and manage common long-term conditions. To identify those who can benefit from such interventions and to deliver tailored support, primary care professionals (e.g. GPs, practice nurses, physiotherapists, health care assistants) need reliable and valid tools to assess physical activity. However, there is uncertainty about the best-performing tool. Objective.: To identify the tools used in the literature to assess the physical activity in primary care and describe their psychometric properties...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334777/clinicians-interpretations-of-point-of-care-urine-culture-versus-laboratory-culture-results-analysis-from-the-four-country-poetic-trial-of-diagnosis-of-uncomplicated-urinary-tract-infection-in-primary-care
#12
Saskia Hullegie, Mandy Wootton, Theo J M Verheij, Emma Thomas-Jones, Janine Bates, Kerenza Hood, Micaela Gal, Nick A Francis, Paul Little, Michael Moore, Carl Llor, Timothy Pickles, David Gillespie, Nigel Kirby, Curt Brugman, Christopher C Butler
Background.: Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. Objective.: To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI)...
March 1, 2017: Family Practice
https://www.readbyqxmd.com/read/28334765/the-operational-context-of-care-sport-connectors-in-the-netherlands
#13
K E F Leenaars, E C van der Velden-Bollemaat, E Smit, A Wagemakers, G R M Molleman, M A Koelen
To stimulate physical activity (PA) and guide primary care patients towards local sport facilities, Care Sport Connectors (CSCs), to whom a broker role has been ascribed, were introduced in 2012 in the Netherlands. The aim of this study is to describe CSCs' operational context. A theoretical framework was developed and used as the starting point for this study. Group interviews were held with policymakers in nine participating municipalities, and, when applicable, the CSC's manager was also present. Prior to the interviews, a first outline of the operational context was mapped, based on the analysis of policy documents and a questionnaire completed by the policymakers...
February 22, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28334754/rate-of-renal-function-decline-race-and-referral-to-nephrology-in-a-large-cohort-of-primary-care-patients
#14
Farrukh M Koraishy, Denise Hooks-Anderson, Joanne Salas, Jeffrey F Scherrer
Introduction.: Late nephrology referral is associated with adverse outcomes especially among minorities. Research on the association of the rate of chronic kidney disease (CKD) progression with nephrology referral in white versus black patients is lacking. Objectives.: Compute the odds of nephrology referral in primary care and their associations with race and the rate of CKD progression. Methods.: Electronic health record data were obtained from 2170 patients in primary care clinics in the Saint Louis metropolitan area with at least two estimated glomerular filtration rate (eGFR) values over a 7-year observation period...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334740/patient-experience-of-primary-care-and-advance-care-planning-a-multicentre-cross-sectional-study-in-japan
#15
Takuya Aoki, Jun Miyashita, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Morito Kise, Yasuki Fujinuma, Shingo Fukuma, Miho Kimachi, Sayaka Shimizu, Shunichi Fukuhara
Background.: Advance care planning (ACP) is becoming increasingly important in the primary care setting because of its positive impact on the end-of-life care. Objective.: We aimed to investigate the relationship between patient experience of primary care and ACP. Methods.: This cross-sectional study was conducted in 28 primary care clinics in Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT), which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided) and community orientation...
January 30, 2017: Family Practice
https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#16
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
March 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#17
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#18
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#19
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334582/improving-diagnostic-safety-in-primary-care-by-unlocking-digital-data
#20
EDITORIAL
Hardeep Singh
No abstract text is available yet for this article.
January 2017: Joint Commission Journal on Quality and Patient Safety
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