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https://www.readbyqxmd.com/read/28933627/primary-care-for-mentally-ill-adults-in-acute-residential-treatment-facilities
#1
Linda Chafetz, Gerri Collins-Bride
Psychiatric bed capacity has decreased nationally with an impact on the number and the types of patients admitted to acute in-patient units. Acute residential programs provide alternatives to hospitals for patients with problems that do not meet criteria for admission. However, these settings may not have resources to respond to the medical co-morbidities associated with severe mental illness. To understand the medical needs of patients in these settings, this research examined data from a nurse-managed primary care outreach service...
September 21, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28932882/no-episiotomy-versus-selective-lateral-mediolateral-episiotomy-epitrial-an-interim-analysis
#2
Lena Sagi-Dain, Rabia Bahous, Orna Caspin, Inna Kreinin-Bleicher, Ron Gonen, Shlomi Sagi
INTRODUCTION AND HYPOTHESIS: The objective of this trial was to evaluate whether avoiding episiotomy can decrease the risk of advanced perineal tears. MATERIAL AND METHODS: In this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into standard care (155 cases) vs. no episiotomy (154 cases) groups. The primary endpoint was the incidence of advanced (3rd- and 4th-degree) perineal tears. Secondary outcomes included perineal integrity, suturing characteristics, second-stage duration, incidence of postpartum hemorrhage, neonatal variables, and various postpartum symptoms 2 days and 2 months after delivery...
September 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28931088/an-integrated-nutrition-and-health-program-package-on-iycn-improves-breastfeeding-but-not-complementary-feeding-and-nutritional-status-in-rural-northern-india-a-quasi-experimental-randomized-longitudinal-study
#3
Veena Singh, Saifuddin Ahmed, Michele L Dreyfuss, Usha Kiran, Deepika N Chaudhery, Vinod K Srivastava, Ramesh C Ahuja, Abdullah H Baqui, Gary L Darmstadt, Mathuram Santosham, Keith P West
BACKGROUND: Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India's standard nutrition and health care program. METHODS: In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected...
2017: PloS One
https://www.readbyqxmd.com/read/28929322/the-importance-of-symbolic-and-engaged-participation-in-evidence-based-quality-improvement-in-a-complex-integrated-healthcare-system-response-to-the-science-of-stakeholder-engagement-in-research
#4
Alison B Hamilton, Elizabeth M Yano
In this commentary, we respond to the commentary provided by Goodman and Sanders Thompson regarding our paper on multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement (EBQI) in women's health primary care. We clarify our overall approach to engagement (comprised of both symbolic and engaged participation, according to the authors' classification rubric), highlighting that symbolic participation is of more import and value than the authors suggest, especially in the context of a hierarchical healthcare system...
September 19, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28929269/behavioral-health-integration-in-health-care-settings-lessons-learned-from-a-pediatric-hospital-primary-care-system
#5
Leandra Godoy, Melissa Long, Donna Marschall, Stacy Hodgkinson, Brooke Bokor, Hope Rhodes, Howard Crumpton, Mark Weissman, Lee Beers
Behavioral health integration within primary care has been evolving, but literature traditionally focuses on smaller scale efforts. We detail how behavioral health has been integrated across a large, urban pediatric hospital system's six primary care clinics (serving over 35,000 children annually and insured predominately through Medicaid) and discuss strategies for success in sustaining and expanding efforts to achieve effective integration of behavioral health into primary care. In a time span of 3 years, the clinics have implemented routine, universal behavioral health screening at well child visits, participated in a 15-month behavioral health screening quality improvement learning collaborative, and integrated the work of psychologists and psychiatrists...
September 19, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28929097/integrated-clinical-decision-support-systems-promote-absolute-cardiovascular-risk-assessment-an-important-primary-prevention-measure-in-aboriginal-and-torres-strait-islander-primary-health-care
#6
Veronica Matthews, Christopher P Burgess, Christine Connors, Elizabeth Moore, David Peiris, David Scrimgeour, Sandra C Thompson, Sarah Larkins, Ross Bailie
BACKGROUND: Aboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD). Despite the importance of absolute cardiovascular risk assessment (CVRA) as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC) sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28928316/integrated-brief-tobacco-and-alcohol-cessation-intervention-in-a-primary-health-care-setting-in-karnataka
#7
O T Sabari Sridhar, Pratima Murthy, K V Kishore Kumar
BACKGROUND: Tobacco and alcohol use are important preventable risk factors for noncommunicable diseases and need to be addressed in primary health care. OBJECTIVES: To find the effectiveness of Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)-based brief intervention for alcohol and tobacco in a primary health-care setting in Karnataka. METHODS: This study was conducted in 2012 where one primary health center (PHC) in Karnataka was an intervention site and other the control site...
September 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28928190/interdisciplinary-model-of-care-radicals-for-early-detection-and-management-of-chronic-obstructive-pulmonary-disease-copd-in-australian-primary-care-study-protocol-for-a-cluster-randomised-controlled-trial
#8
Jenifer Liang, Michael J Abramson, Nicholas Zwar, Grant Russell, Anne E Holland, Billie Bonevski, Ajay Mahal, Benjamin van Hecke, Kirsten Phillips, Paula Eustace, Eldho Paul, Kate Petrie, Sally Wilson, Johnson George
INTRODUCTION: Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. METHODS AND ANALYSIS: A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS - Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers)...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#9
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28928111/personalized-hypertension-management-using-patient-generated-health-data-integrated-with-electronic-health-records-empower-h-six-month-pre-post-study
#10
Nan Lv, Lan Xiao, Martha L Simmons, Lisa G Rosas, Albert Chan, Martin Entwistle
BACKGROUND: EMPOWER-H (Engaging and Motivating Patients Online With Enhanced Resources-Hypertension) is a personalized-care model facilitating engagement in hypertension self-management utilizing an interactive Web-based disease management system integrated with the electronic health record. The model is designed to support timely patient-provider interaction by incorporating decision support technology to individualize care and provide personalized feedback for patients with chronic disease...
September 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28926384/effect-of-surgeon-and-hospital-volume-on-morbidity-and-mortality-after-hip-fracture
#11
Kanu Okike, Priscilla H Chan, Elizabeth W Paxton
BACKGROUND: Prior studies have examined the relationship between surgeon and hospital volumes and outcome following hip fracture surgical procedures, but the results have been inconclusive. The purpose of this study was to assess the hip fracture volume-outcome relationship by analyzing data from a large, managed care registry. METHODS: The Kaiser Permanente Hip Fracture Registry prospectively records information on surgically treated hip fractures within the managed health-care system...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28925813/what-patients-think-about-choice-in-healthcare-a-study-on-primary-care-services-in-finland
#12
Anna-Mari Aalto, Marko Elovainio, Liina-Kaisa Tynkkynen, Eeva Reissell, Tuulikki Vehko, Miisa Chydenius, Timo Sinervo
BACKGROUND: The ongoing Finnish health and social service reform will expand choice by opening the market for competition between public and private service providers. This study examined the attitudes of primary care patients towards choice and which patient-related factors are associated with these attitudes. METHODS: A sample of attenders during one week in health centres of 12 big cities and municipal consortiums (including seven outsourced local units) and in primary care units of one private company providing outsourced services for municipalities (aged 18-95, n=8128) was used...
September 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28925746/impact-of-extended-monitoring-guided-intensive-care-on-outcome-after-severe-traumatic-brain-injury-a-prospective-multicentre-cohort-study-paris-tbi-study
#13
Joaquim Mateo, Didier Payen, Idir Ghout, Fabrice Vallée, Thomas Lescot, Stephane Welschbillig, Karim Tazarourte, Philippe Azouvi, Jean-Jacques Weiss, Philippe Aegerter, Bernard Vigué
OBJECTIVE: We evaluated whether an integrated monitoring with systemic and specific monitoring affect mortality and disability in adults with severe traumatic brain injury (sTBI). METHODS: Adults with severeTBI (Glasgow Coma Scale [GCS] ≤ 8) admitted alive in intensive care units (ICUs) were prospectively included. Primary endpoints were in-hospital 30-day mortality and extended Glasgow outcome score (GOSE) at 3 years. Association with the intensity of monitoring and outcome was studied by comparing a high level of monitoring (HLM) (systemic and ≥3 specific monitoring) and low level of monitoring (LLM) (systemic and 0-2 specific monitoring) and using inverse probability weighting procedure...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28925010/temporal-trends-in-quality-of-primary-care-for-patients-with-type-2-diabetes-mellitus-a-population-based-retrospective-cohort-study-after-implementation-of-a-quality-improvement-initiative
#14
Carlos K H Wong, Colman S C Fung, Esther Y T Yu, Eric Y F Wan, Anca K C Chan, Cindy L K Lam
BACKGROUND: This study examined whether temporal trends exist in treatment of patients with type 2 diabetes (T2D) and quality of diabetes care after implementation of quality improvement initiative in primary care setting. METHODS: We conducted a population-based retrospective cohort study of 202,284 patients with T2D who were routinely managed in primary care clinics. We examined the change over time and the variability between clinics in quality-of-care from Hospital Authority administrative data over a five-year period (2009-2013), and used multilevel logistic regression to adjust for patient and clinic characteristics...
September 19, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28924245/understanding-the-factors-affecting-self-management-of-copd-from-the-perspectives-of-healthcare-practitioners-a-qualitative-study
#15
Oladapo J Ogunbayo, Sian Russell, James J Newham, Karen Heslop-Marshall, Paul Netts, Barbara Hanratty, Eileen Kaner
Self-management is recognised as an essential criteria for the provision of high quality care for chronic obstructive pulmonary disease (COPD). The management of COPD is usually delivered by a wide range of healthcare practitioners. This study aimed to understand the factors affecting self-management of COPD from the perspectives of the different multidisciplinary healthcare teams involved in COPD care. Semi-structured interviews were conducted with participants from primary care, specialist respiratory and pulmonary rehabilitation (PR) teams...
September 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28923812/primary-care-and-public-health-perspectives-on-integration-at-the-local-level-a-multi-state-study
#16
Rebekah Pratt, Beth Gyllstrom, Kim Gearin, David Hahn, Lisa VanRaemdonck, Kevin Peterson, Laura-Mae Baldwin
OBJECTIVE: The Institute of Medicine argues that the integration of primary care (PC) and public health (PH) is of paramount importance. We undertook this qualitative study to better understand how these collaborations function. DATA SOURCES: Investigators from PC and PH practice-based research networks in Colorado, Minnesota, Washington, and Wisconsin identified 40 key informants from the PH and PC fields within their respective states. STUDY DESIGN: The key informants participated in standardized, semistructured interviews...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28922571/interprofessional-oral-health-initiative-in-a-nondental-american-indian-setting
#17
Kate L Murphy, Laura S Larsson
BACKGROUND AND PURPOSE: Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. METHODS: The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral...
September 18, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28922295/spiritual-needs-of-patients-with-cancer-in-palliative-care-an-integrative-review
#18
Ana Cláudia Mesquita, Érika de Cássia Lopes Chaves, Guilherme Antônio Moreira de Barros
PURPOSE OF REVIEW: The experience of a life crisis, such as the experience of end-of-life terminality whenever facing cancer can make the spiritual needs of patients clear. The goal of this revision was to synthesize the existing evidence regarding the spiritual needs of patients with cancer in palliative care. RECENT FINDINGS: An integrated revision of the literature was conducted regarding the database sources from PubMed, CINAHL, EMBASE, LILACS and Scopus, without publishing year restrictions...
September 15, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28920521/implementing-evidence-based-smoking-cessation-treatment-in-psychosocial-care-units-caps-in-brazil
#19
João Mauricio Castaldelli-Maia, Nilson R da Silva, Marta Rd Campos, Helena F Moura, Gustavo Zabert, Beatriz M Champagne, Katherine E Kemper, J Taylor Hays
BACKGROUND: The prevalence of smoking among mental health and addiction (MHA) patients is 3 times higher than it is in the general population, yet this patient population has received little help to combat smoking. Considering this, psychosocial care centers (CAPS - Centros de Atenção Psicossocial) are strategic locations for integrating tobacco dependence treatment (TDT) into existing treatment activities. METHODS: Our team provided an 8-hour training package to the staff of CAPS that have not been providing specialized TDT for smokers...
September 1, 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/28917688/a-randomized-trial-of-pocket-echocardiography-integrated-mobile-health-device-assessments-in-modern-structural-heart-disease-clinics
#20
Sanjeev P Bhavnani, Srikanth Sola, David Adams, Ashwin Venkateshvaran, P K Dash, Partho P Sengupta
OBJECTIVES: This study sought to determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). BACKGROUND: Newly developed smartphone-connected mHealth devices represent promising methods to diagnose common diseases in resource-limited areas; however, the impact of technology-based care on long-term outcomes has not been rigorously evaluated...
September 9, 2017: JACC. Cardiovascular Imaging
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