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https://www.readbyqxmd.com/read/28934562/the-enduring-legacy-of-250-years-of-pharmacology-in-edinburgh
#1
John S Kelly, Angus V P Mackay
Two hundred fifty years ago, the University of Edinburgh appointed Francis Home to the first chair of materia medica, the accumulated knowledge of materials used in healing. Francis Home and his colleagues were determined to improve the quality of medical training in Edinburgh by introducing a final examination and compiling a catalog of medicines validated by the Royal College of Physicians of Edinburgh. The catalog, known as the Edinburgh Pharmacopoeia, was a great success, partly due to the orderly nature of its contents, its routine editing to eliminate worthless entries, and the introduction of new treatments whose preparation was precisely documented...
September 13, 2017: Annual Review of Pharmacology and Toxicology
https://www.readbyqxmd.com/read/28934403/improving-inpatient-medication-adherence-using-attendant-education-in-a-tertiary-care-hospital-in-uganda
#2
Patricia Alupo, Richard Ssekitoleko, Tracy Rabin, Robert Kalyesubula, Ivan Kimuli, Benjamin E Bodnar
Quality problem: Although widely utilized in resource-rich health care systems, the use of quality improvement (QI) techniques is less common in resource-limited environments. Uganda is a resource-limited country in Sub-Saharan Africa that faces many challenges with health care delivery. These challenges include understaffing, inconsistent drug availability and inefficient systems that limit the provision of clinical care. Initial assessment: Poor adherence to prescribed inpatient medications was identified as a key shortcoming of clinical care on the internal medicine wards of Mulago National Referral Hospital, Kampala, Uganda...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28934258/reports-of-unintended-consequences-of-financial-incentives-to-improve-management-of-hypertension
#3
Sylvia J Hysong, Richard SoRelle, Kristen Broussard Smitham, Laura A Petersen
BACKGROUND: Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives...
2017: PloS One
https://www.readbyqxmd.com/read/28932160/family-medicine-practice-in-saudi-arabia-the-current-situation-and-proposed-strategic-directions-plan-2020
#4
Yahia M Al-Khaldi, Essam A Al-Ghamdi, Tariq I Al-Mogbil, Hesham I Al-Khashan
OBJECTIVES: The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. MATERIALS AND METHODS: This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015...
September 2017: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#5
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28929875/using-structured-incentives-to-increase-value-for-money-in-an-academic-health-sciences-centre
#6
Guy J Hébert, Connie Colasante, Renate G Ilse, Alan J Forster
As healthcare continues to consume more and more of provincial government spending, there is a continuing pressure to improve efficiency and cut overall costs. In this increasingly constrained healthcare system, value for money is a growing focus of discussions around accountability and system sustainability; healthcare leaders are required to find ways of measuring, enforcing, and reporting on that value. In 2014, our organization began implementing an innovative system of structured incentives, linking distribution of Ministry of Health and Long-Term Care academic physician funding to quality and performance goals...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#7
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28928841/lung-cancer-requires-multidisciplinary-treatment-to-improve-patient-survival-a-case-report
#8
Aldo Pezzuto, Fabrizio Terzo, Maria Laura Graziani, Alberto Ricci, Pierdonato Bruno, Salvatore Mariotta
The present study reports two cases of lung cancer with the involvement of the pleura. The diagnosis of adenocarcinoma with epidermal growth factor receptor (EGFR) mutation was made following repeated thoracentesis with cytology of pleural fluid and thoracoscopy with pleural biopsies. Talc pleurodesis was successfully performed in both cases subsequent to diagnosis. Following talc pleurodesis, the first patient (62 years old; male; non-smoker) underwent 3 cycles of cisplatin/vinorelbine chemotherapy, with a poor response...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28927493/review-of-patient-reported-experience-within-patient-centered-medical-homes-insights-for-australian-health-care-homes
#9
Mary O'Loughlin, Jane Mills, Robyn McDermott, Linton Harriss
Understanding patient experience is necessary to advance the patient-centred approach to health service delivery. Australia's primary healthcare model, the 'Health Care Home', is based on the 'Patient-Centered Medical Home' (PCMH) model developed in the United States. Both these models aim to improve patient experience; however, the majority of existing PCMH model evaluations have focussed on funding, management and quality assurance measures. This review investigated the scope of evidence reported by adult patients using a PCMH...
September 20, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28927448/barriers-and-facilitators-to-implementing-addiction-medicine-fellowships-a-qualitative-study-with-fellows-medical-students-residents-and-preceptors
#10
J Klimas, W Small, K Ahamad, W Cullen, A Mead, L Rieb, E Wood, R McNeil
BACKGROUND: Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships...
September 20, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28926751/collaboration-of-midwives-in-primary-care-midwifery-practices-with-other-maternity-care-providers
#11
J Catja Warmelink, Therese A Wiegers, T Paul de Cock, Trudy Klomp, Eileen K Hutton
BACKGROUND: Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians...
September 6, 2017: Midwifery
https://www.readbyqxmd.com/read/28926388/opportunistic-use-of-ct-imaging-for-osteoporosis-screening-and-bone-density-assessment-a-qualitative-systematic-review
#12
Elizabeth B Gausden, Benedict U Nwachukwu, Joseph J Schreiber, Dean G Lorich, Joseph M Lane
BACKGROUND: The purpose of this study was to determine the clinical opportunities for the use of computed tomography (CT) imaging for inferring bone quality and to critically analyze the correlation between dual x-ray absorptiometry (DXA) and diagnostic CT as reported in the literature. METHODS: A systematic review of the MEDLINE database was performed in February 2016 using the PubMed interface. The inclusion criteria were English language, studies performed using living human subjects, studies pertaining to orthopaedics, use of conventional diagnostic CT scans, studies that measured cancellous bone, and studies that reported Hounsfield unit (HU) measurements directly rather than a computed bone mineral density...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#13
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925635/diabetes-self-management-facilitating-lifestyle-change
#14
Marlon Russell Koenigsberg, Jennifer Corliss
Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. During office visits, physicians should assess and gradually encourage patients' readiness to work toward change...
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924697/chiropractic-spinal-manipulation-and-the-risk-for-acute-lumbar-disc-herniation-a-belief-elicitation-study
#15
Cesar A Hincapié, J David Cassidy, Pierre Côté, Y Raja Rampersaud, Alejandro R Jadad, George A Tomlinson
PURPOSE: Chiropractic spinal manipulation treatment (SMT) is common for back pain and has been reported to increase the risk for lumbar disc herniation (LDH), but there is no high quality evidence about this. In the absence of good evidence, clinicians can have knowledge and beliefs about the risk. Our purpose was to determine clinicians' beliefs regarding the risk for acute LDH associated with chiropractic SMT. METHODS: Using a belief elicitation design, 47 clinicians (16 chiropractors, 15 family physicians and 16 spine surgeons) that treat patients with back pain from primary and tertiary care practices were interviewed...
September 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28923820/family-medicine-in-ethiopia-lessons-from-a-global-collaboration
#16
Ann Evensen, Dawit Wondimagegn, Daniel Zemenfes Ashebir, Katherine Rouleau, Cynthia Haq, Abbas Ghavam-Rassoul, Praseedha Janakiram, Elizabeth Kvach, Heidi Busse, James Conniff, Brian Cornelson
BACKGROUND: Building the capacity of local health systems to provide high-quality, self-sustaining medical education and health care is the central purpose for many global health partnerships (GHPs). Since 2001, our global partner consortium collaborated to establish Family Medicine in Ethiopia; the first Ethiopian family physicians graduated in February 2016. METHODS: The authors, representing the primary Ethiopian, Canadian, and American partners in the GHP, identified obstacles, accomplishments, opportunities, errors, and observations from the years preceding residency launch and the first 3 years of the residency...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923492/rationale-and-design-of-the-atrial-fibrillation-health-literacy-information-technology-trial-af-litt
#17
Emily N Guhl, Courtney L Schlusser, Lori E Henault, Timothy W Bickmore, Everlyne Kimani, Michael K Paasche-Orlow, Jared W Magnani
BACKGROUND: Atrial Fibrillation (AF) is a common cardiac arrhythmia that is challenging for patients and adversely impacts health-related quality of life (HRQoL). Long-term management of AF requires that patients adhere to complex therapies, understand difficult terminology, navigate subspecialty care, and have continued symptom monitoring with the goal of preventing adverse outcomes. Continued interventions to ameliorate the patient experience of AF are essential. DESIGN: The Atrial Fibrillation health Literacy Information Technology Trial (AF-LITT; NCT03093558) is an investigator-initiated, 2-arm randomized clinical trial (RCT)...
September 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#18
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920710/use-of-strong-opioids-for-chronic-pain-in-osteoarthritis-an-insight-into-the-latin-american-reality
#19
Miguel Angel Ruiz Iban, Javier Benavides, Juan Pablo Forero, Sacha Bittelman, Rafael Martinez, Miguel Angel Mite, Jorge Diaz Heredia, Sergio Ulloa, Mauro Marcelo Lizárraga Ferrand
Osteoarthritis is the most common cause of arthritis and one of the principle causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids...
September 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28917712/toward-classification-criteria-for-early-osteoarthritis-of-the-knee
#20
F P Luyten, S Bierma-Zeinstra, F Dell'Accio, V B Kraus, K Nakata, I Sekiya, N K Arden, L S Lohmander
OBJECTIVE: To propose draft classification criteria for early stage osteoarthritis (OA) of the knee for use in a primary care setting. METHODS: A group of basic scientists, physician-scientists, rheumatologists, orthopedic surgeons, and physiotherapists in a workshop setting discussed potential classification criteria for early osteoarthritis of the knee. The workshop was divided into sessions around relevant topics with short state of the art presentations followed by breakout sessions, consensus discussions, and consolidation into a consensus document...
August 9, 2017: Seminars in Arthritis and Rheumatism
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