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https://www.readbyqxmd.com/read/28535316/residents-confidence-providing-primary-care-with-behavioral-health-integration
#1
Patrick Hemming, Amber Hewitt, Joseph J Gallo, Rodger Kessler, R B Levine
BACKGROUND AND OBJECTIVES: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28532861/an-evaluation-of-two-interventions-to-enhance-patient-physician-communication-using-the-observer-option-5-measure-of-shared-decision-making
#2
Ellis C Dillon, Cheryl D Stults, Caroline Wilson, Judith Chuang, Amy Meehan, Martina Li, Glyn Elwyn, Dominick L Frosch, Edward Yu, Ming Tai-Seale
OBJECTIVE: Evaluate interventions to enhance patient-physician communication and shared decision making (SDM). METHODS: We used Observer OPTION(5) to evaluate primary care visits within a cluster randomized controlled trial in a California delivery organization. Trial interventions included Open Communication (OpenComm), combining patient activation and physician coaching, and AskShareKnow, a patient activation tool, and were compared to a usual care arm. Scores were analyzed with descriptive statistics and generalized estimating equation analysis for 40 visits containing 200 decision topics...
May 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28529529/disclosure-of-traditional-and-complementary-medicine-use-and-its-associated-factors-to-medical-doctor-in-primary-care-clinics-in-kuching-division-sarawak-malaysia
#3
Anak Kelak Johny, Whye Lian Cheah, Safii Razitasham
The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28527635/shared-decision-making-in-preventive-care-in-switzerland-from-theory-to-action
#4
Kevin Selby, Reto Auer, Jacques Cornuz
Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28525291/the-state-of-opioid-agonist-therapy-in-canada-20-years-after-federal-oversight
#5
Joseph K Eibl, Kristen Morin, Esa Leinonen, David C Marsh
Opioid agonist therapy was introduced in Canada in 1959 with the use of methadone for the treatment of opioid dependence. The regulation of methadone was the responsibility of Health Canada until 1995, when oversight was transferred to the provincial health systems. During the more than 20 years since the federal health authority transferred oversight of methadone to the provincial level, methadone programming has evolved differently in every province. The landscape of opioid dependence treatment is varied across the country, with generally increasing treatment capacity in all provinces and dramatic increases in some...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#6
Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
BACKGROUND: Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521751/an-integrated-intervention-to-reduce-intimate-partner-violence-and-psychological-distress-with-refugees-in-low-resource-settings-study-protocol-for-the-nguvu-cluster-randomized-trial
#7
Wietse A Tol, M Claire Greene, Samuel Likindikoki, Lusia Misinzo, Peter Ventevogel, Ann G Bonz, Judith K Bass, Jessie K K Mbwambo
BACKGROUND: Intimate partner violence (IPV) is a critical public health and human rights concern globally, including for refugee women in low-resource settings. Little is known about effective interventions for this population. IPV and psychological distress have a bi-directional relationship, indicating the potential benefit of a structured psychological component as part of efforts to reduce IPV for women currently in violent relationships. METHODS: This protocol describes a cluster randomized controlled trial aimed at evaluating an 8-session integrated psychological and advocacy intervention (Nguvu) with female adult survivors of past-year IPV displaying moderate to severe psychological distress...
May 18, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28521749/service-user-involvement-in-mental-health-system-strengthening-in-a-rural-african-setting-qualitative-study
#8
Sisay Abayneh, Heidi Lempp, Atalay Alem, Daniel Alemayehu, Tigist Eshetu, Crick Lund, Maya Semrau, Graham Thornicroft, Charlotte Hanlon
BACKGROUND: It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. METHODS: Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8)...
May 18, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28520962/systematic-short-term-pulmonary-rehabilitation-before-lung-cancer-lobectomy-a-randomized-trial
#9
Yutian Lai, Jianhua Su, Peiyuan Qiu, Mingming Wang, Kun Zhou, Yuxin Tang, Guowei Che
OBJECTIVES: The goal of this study was to assess the impact of a preoperative 1-week, systematic, high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications (PPCs). METHODS: We conducted a randomized controlled trial with 101 subjects of a preoperative, 7-day systematic, integrated, high-intensity pulmonary exercise regimen. The control group received standard preoperative care. We analysed the occurrence of PPCs in both groups as the primary outcome; other outcomes included changes in blood gas, quality of life, peak expiratory flow rate, the 6-min walk distance and others...
May 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28515505/application-of-the-layered-learning-practice-model-in-an-academic-medical-center
#10
Brittany M Loy, Sendra Yang, Jason M Moss, Debra W Kemp, Jamie N Brown
The layered learning practice model (LLPM) is a teaching strategy designed to train residents to precept students and other residents with the oversight of a seasoned clinical pharmacist. This model serves as a tool for residency programs to implement quality precepting opportunities and learning experiences as they look for new ways to integrate multiple learners into the practice setting. The levels of the LLPM include a senior preceptor, resident, and student. It is best implemented through utilization of 4 steps: orientation to the LLPM, preexperience planning, implementation, and postexperience evaluation...
April 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28512685/modeling-brain-lentiviral-infections-during-antiretroviral-therapy-in-aids
#11
Weston C Roda, Michael Y Li, Michael S Akinwumi, Eugene L Asahchop, Benjamin B Gelman, Kenneth W Witwer, Christopher Power
Understanding HIV-1 replication and latency in different reservoirs is an ongoing challenge in the care of patients with HIV/AIDS. A mathematical model was created to describe and predict the viral dynamics of HIV-1 and SIV infection within the brain during effective combination antiretroviral therapy (cART). The mathematical model was formulated based on the biology of lentiviral infection of brain macrophages and used to describe the dynamics of transmission and progression of lentiviral infection in brain...
May 16, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28512119/complementary-and-integrative-medicine-in-the-management-of-headache
#12
REVIEW
Denise Millstine, Christina Y Chen, Brent Bauer
Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs)...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28509654/clinical-reasoning-embodied-meaning-making-in-physiotherapy
#13
Anoop Chowdhury, Wenche Schrøder Bjorbækmo
This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes...
May 16, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28509565/a-qualitative-meta-summary-using-sandelowski-and-barroso-s-method-for-integrating-qualitative-research-to-explore-barriers-and-facilitators-to-self-care-in-heart-failure-patients
#14
Oliver Rudolf Herber, Bettina Bücker, Maria-Inti Metzendorf, Julie Barroso
BACKGROUND: Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. AIM: The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. METHODS: Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28508140/the-state-and-future-of-the-primary-care-behavioral-health-model-of-service-delivery-workforce
#15
Neftali Serrano, Colleen Cordes, Barbara Cubic, Suzanne Daub
The growth of the Primary Care Behavioral Health model (PCBH) nationally has highlighted and created a workforce development challenge given that most mental health professionals are not trained for primary care specialization. This work provides a review of the current efforts to retrain mental health professionals to fulfill roles as Behavioral Health Consultants (BHCs) including certificate programs, technical assistance programs, literature and on-the-job training, as well as detail the future needs of the workforce if the model is to sustainably proliferate...
May 15, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28507010/a-systematic-review-of-application-and-effectiveness-of-mhealth-interventions-for-obesity-and-diabetes-treatment-and-self-management
#16
REVIEW
Youfa Wang, Hong Xue, Yaqi Huang, Lili Huang, Dongsong Zhang
The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among patients with chronic diseases such as obesity and diabetes. This study comprehensively examined published mHealth intervention studies for obesity and diabetes treatment and management to assess their effectiveness and provide recommendations for future research. We systematically searched PubMed for mHealth-related studies on diabetes and obesity treatment and management published during 2000-2016...
May 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28506574/the-degree-of-integration-of-non-dispensing-pharmacists-in-primary-care-practice-and-the-impact-on-health-outcomes-a-systematic-review
#17
REVIEW
Ankie C M Hazen, Antoinette A de Bont, Lia Boelman, Dorien L M Zwart, Johan J de Gier, Niek J de Wit, Marcel L Bouvy
BACKGROUND: A non-dispensing pharmacist conducts clinical pharmacy services aimed at optimizing patients individual pharmacotherapy. Embedding a non-dispensing pharmacist in primary care practice enables collaboration, probably enhancing patient care. The degree of integration of non-dispensing pharmacists into multidisciplinary health care teams varies strongly between settings. The degree of integration may be a determinant for its success. OBJECTIVES: This study investigates how the degree of integration of a non-dispensing pharmacist impacts medication related health outcomes in primary care...
April 22, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28506486/preoperative-and-intraoperative-neurophysiological-investigations-for-surgical-resections-in-functional-areas
#18
G Huberfeld, A Trébuchon, L Capelle, J-M Badier, S Chen, J-P Lefaucheur, M Gavaret
Brain regions are removed to treat lesions, but great care must be taken not to disturb or remove functional areas in the lesion and in surrounding tissue where healthy and diseased cells may be intermingled, especially for infiltrating tumors. Cortical functional areas and fiber tracts can be localized preoperatively by probabilistic anatomical tools, but mapping of functional integrity by neurophysiology is essential. Identification of the primary motor cortex seems to be more effectively performed with transcranial magnetic stimulation (TMS) than functional magnetic resonance imaging (fMRI)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28506141/a-pragmatic-guide-to-the-setting-up-of-integrated-hypnotherapy-services-in-primary-care-and-clinical-settings
#19
Paul Andrew Entwistle
Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services...
July 2017: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/28504785/addressing-noncommunicable-diseases-in-primary-care-the-case-of-type-2-diabetes
#20
K M Narayan, E C Rhodes
The rapid growth of noncommunicable diseases represents a formidable global health challenge. Here we use type 2 diabetes as a case study to illustrate the rise of noncommunicable diseases and call attention to the important role of primary care systems in addressing these diseases in low- and middle-income countries. Comprehensive screening for diabetes should be implemented through primary care systems to increase early detection of prediabetes and undiagnosed diabetes - a first step to diabetes prevention and management...
December 2016: Journal of the Royal College of Physicians of Edinburgh
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