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https://www.readbyqxmd.com/read/29333493/a-quality-improvement-project-aimed-at-adapting-primary-care-to-ensure-the-delivery-of-evidence-based-psychotherapy-for-adult-anxiety
#1
Mark D Williams, Craig N Sawchuk, Nathan D Shippee, Kristin J Somers, Summer L Berg, Jay D Mitchell, Angela B Mattson, David J Katzelnick
Primary care patients frequently present with anxiety with prevalence ratios up to 30%. Brief cognitive-behavioural therapy (CBT) has been shown in meta-analytic studies to have a strong effect size in the treatment of anxiety. However, in surveys of anxious primary care patients, nearly 80% indicated that they had not received CBT. In 2010, a model of CBT (Coordinated Anxiety Learning and Management (CALM)) adapted to primary care for adult anxiety was published based on results of a randomised controlled trial...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29331474/clinical-databases-for-chest-physicians
#2
REVIEW
Andrew M Courtwright, Peter E Gabriel
A clinical database is a repository of patient medical and sociodemographic information focused on one or more specific health condition or exposure. Although clinical databases may be used for research purposes, their primary goal is to collect and track patient data for quality improvement, quality assurance, and/or actual clinical management. This article aims to provide an introduction and practical advice on the development of small-scale clinical databases for Chest physicians and practice groups. Through example projects we discuss the pros and cons of available technical platforms, including Microsoft Excel and Access, relational database management systems such as Oracle and PostgreSQL, and REDCap...
January 10, 2018: Chest
https://www.readbyqxmd.com/read/29326094/a-shared-decision-making-tool-to-prevent-substance-abuse-protocol-for-a-randomized-controlled-trial
#3
Ju Long, Juntao Michael Yuan, Ron Kim Johnson
BACKGROUND: Substance use disorder (SUD) affects over 20 million adults and costs over $700 billion annually in the United States. It is one the greatest health care challenges we face. OBJECTIVE: This research project seeks to enhance the standard practice of Screening, Brief Intervention, and Referral to Treatment (SBIRT) through a mobile solution easily incorporated into primary care that will promote shared decision making and increase referral and adherence to specialty care through continued follow-up care...
January 11, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29325519/providers-preferences-for-pediatric-oral-health-information-in-the-electronic-health-record-a-cross-sectional-survey
#4
Christopher M Shea, Kea Turner, B Alex White, Ye Zhu, R Gary Rozier
BACKGROUND: The majority of primary care physicians support integration of children's oral health promotion and disease prevention into their practices but can experience challenges integrating oral health services into their workflow. Most electronic health records (EHRs) in primary care settings do not include oral health information for pediatric patients. Therefore, it is important to understand providers' preferences for oral health information within the EHR. The objectives of this study are to assess (1) the relative importance of various elements of pediatric oral health information for primary care providers to have in the EHR and (2) the extent to which practice and provider characteristics are associated with these information preferences...
January 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29319251/time-to-revisit-recommendations-on-doctor-to-population-ratio-in-india
#5
Madhav G Deo
A buzzword in Indian press and amongst the policy makers is that India is short of the WHO recommended doctor to population ratio of 1:1000. The recommendations were formulated to facilitate programs to achieve some of the health related UN-Millennium Development Goals (MDGs). Infections and malnutrition, which can be comfortably handled by a basic MBBS doctor, were the dominant health issues at the time of the formulation of the MDGs. However, all countries worldwide are going through health epidemiological transition and health impact of the non-communicable disorders (NCDs) can be no more ignored even by the low income nations...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29311173/a-longitudinal-study-of-interactions-between-health-professionals-and-people-with-newly-diagnosed-diabetes
#6
Anthony Dowell, Maria Stubbe, Lindsay Macdonald, Rachel Tester, Lesley Gray, Sue Vernall, Tim Kenealy, Nicolette Sheridan, Barbara Docherty, Devi-Ann Hall, Deborah Raphael, Kevin Dew
PURPOSE: We undertook a study to observe in detail the primary care interactions and communications of patients with newly diagnosed diabetes over time. In addition, we sought to identify key points in the process where miscommunication might occur. METHODS: All health interactions of 32 patients with newly diagnosed type 2 diabetes were recorded and tracked as they moved through the New Zealand health care system for a period of approximately 6 months. Data included video recordings of patient interactions with the health professionals involved in their care (eg, general practitioners, nurses, dietitians)...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29299817/two-novel-urban-health-primary-care-residency-tracks-that-focus-on-community-level-structural-vulnerabilities
#7
Benjamin J Oldfield, Bennett W Clark, Monica C Mix, Katherine C Shaw, Janet R Serwint, Sanjay V Desai, Rachel M Kruzan, Rosalyn W Stewart, Sebastian Ruhs, Leonard S Feldman
BACKGROUND: Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. AIM: To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents. SETTING: Academic hospital, community health center, and community-based organizations...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29288470/assessing-racial-disparities-in-hcv-infection-and-care-outcomes-in-a-southern-urban-population
#8
Keanan McGonigle, Tess Carley, Clarissa Hoff
OBJECTIVES: This study assessed racial disparities in access to healthcare services, hepatitis C virus (HCV) exposure, and retention in a treatment cascade in two indigent populations in an urban center in the Southern US. PARTICIPANTS/METHODS: Opt-in HCV antibody screening was offered at two large homeless centers and three residential substance abuse treatment centers (SATCs) in New Orleans, LA. Five hundred ninety-four participants experiencing homelessness and 342 residents of SATCs were assessed for previous access/perceived barriers to healthcare services and high-risk behaviors associated with HCV exposure...
December 29, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29279282/parent-perceptions-of-dentists-role-in-hpv-vaccination
#9
Gabriela E Lazalde, Melissa B Gilkey, Melanie L Kornides, Annie-Laurie McRee
INTRODUCTION: Offering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision. METHODS: In September 2016, we conducted an online survey using a national sample (n = 1209) of U...
December 23, 2017: Vaccine
https://www.readbyqxmd.com/read/29278566/job-openings-for-pas-by-specialty
#10
Perri Morgan, Brandi Leach, Kristine Himmerick, Christine Everett
OBJECTIVE: Physician assistants (PAs) have adapted to roles in virtually every practice specialty. One factor that has affected PAs' specialty choices has been the availability of jobs. We describe 2014 job postings for PAs at the national level by practice specialty. METHODS: National data on 2014 job postings for PAs were obtained from a leading labor analytics firm. Each job posting (N = 34,137) was coded with regard to practice specialty and analyzed descriptively...
January 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29273048/propel-implementation-of-an-evidence-based-pelvic-floor-muscle-training-intervention-for-women-with-pelvic-organ-prolapse-a-realist-evaluation-and-outcomes-study-protocol
#11
Margaret Maxwell, Karen Semple, Sarah Wane, Andrew Elders, Edward Duncan, Purva Abhyankar, Joyce Wilkinson, Douglas Tincello, Eileen Calveley, Mary MacFarlane, Doreen McClurg, Karen Guerrero, Helen Mason, Suzanne Hagen
BACKGROUND: Pelvic Organ Prolapse (POP) is estimated to affect 41%-50% of women aged over 40. Findings from the multi-centre randomised controlled "Pelvic Organ Prolapse PhysiotherapY" (POPPY) trial showed that individualised pelvic floor muscle training (PFMT) was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. However, provision of PFMT for prolapse continues to vary across the UK, with limited numbers of women's health physiotherapists specialising in its delivery...
December 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29261835/comparison-of-tumor-classifications-for-cutaneous-squamous-cell-carcinoma-of-the-head-and-neck-in-the-7th-vs-8th-edition-of-the-ajcc-cancer-staging-manual
#12
Pritesh S Karia, Frederick C Morgan, Joseph A Califano, Chrysalyne D Schmults
Importance: Previous studies have shown that the AJCC Cancer Staging Manual, 7th edition (AJCC 7), tumor classification for cutaneous squamous cell carcinoma (CSCC) failed to accurately stratify disease-related outcomes. The recently released 8th edition (AJCC 8) features a revised tumor classification for only head and neck CSCC (HNCSCC). Objective: To compare AJCC 7 and AJCC 8 tumor classifications for HNCSCC and to validate AJCC 8. Design, Setting, and Participants: This was a 10-year retrospective cohort study (2000-2009) at an academic tertiary care center reviewing 680 primary HNCSCC tumors in 459 patients...
December 20, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29251207/perioperative-outcomes-from-the-prospective-multicenter-least-invasive-fast-track-evar-life-registry
#13
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( ClinicalTrials.gov identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29248033/practicing-safety-a-quality-improvement-intervention-to-test-tools-to-enhance-pediatric-psychosocial-care-for-children-0-3-years
#14
Diane J Abatemarco, Ruth S Gubernick, Marianna D LaNoue, Ryan T Pohlig, Sara R Slovin, Jill A Healy, Steven Kairys
BACKGROUND: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents. OBJECTIVE: This paper describes the testing of bundles of tools and processes, part of a larger intervention, Practicing Safety, targeted at changing physician and staff behavior to identify families at risk for child maltreatment, provide anticipatory guidance, refer to community resources, and follow-up and track at-risk families...
December 18, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29241615/provision-of-medical-supply-kits-to-improve-quality-of-antenatal-care-in-mozambique-a-stepped-wedge-cluster-randomised-trial
#15
Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu
BACKGROUND: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. METHODS: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29239152/the-safety-and-efficiency-of-a-fast-track-protocol-for-sleeve-gastrectomy-a-team-approach
#16
Sebastiaan J Vreeswijk, Pim W van Rutte, Simon W Nienhuijs, R Arthur Bouwman, J Frans Smulders, Marc P Buise
BACKGROUND: Increasing numbers of morbid obese patients has led to increased numbers of bariatric procedures. Fast-track protocols are being developed to enhance the available resources, while maintaining a safe procedure. Reported results on safety merely apply to a mixed bariatric population. The objective was to evaluate safety and efficiency of the fast-track principles in patients undergoing sleeve gastrectomy. METHODS: Retrospective observational study including patients undergoing primary sleeve gastrectomy at the Obesity Centre of the Catharina Hospital Eindhoven, the Netherlands...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29237583/high-yield-hiv-testing-facilitated-linkage-to-care-and-prevention-for-female-youth-in-kenya-girls-study-implementation-science-protocol-for-a-priority-population
#17
Irene Inwani, Nok Chhun, Kawango Agot, Charles M Cleland, Jasmine Buttolph, Harsha Thirumurthy, Ann E Kurth
BACKGROUND: Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. OBJECTIVE: Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections...
December 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29233323/evaluation-of-two-different-poverty-simulations-with-professional-phase-pharmacy-students
#18
Carriann Smith, Priscilla Ryder, Meghan Blais, Ryan Schneck
BACKGROUND AND PURPOSE: Pharmacy students will interact with patients who struggle to receive the health care they need. Since attitudes can influence behavior, exposure to these struggles may positively improve patient care. This study evaluates a group of student responses to two different interventions approximately 9 months apart. The primary objectives of this study were to: (1) identify if SPENT, an online game, could alone improve students' attitudes towards those living in poverty, (2) determine if changes imparted by SPENT were retained for nine months, and (3) identify if CAPS, a live simulation, has an additional benefit...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29216748/quality-of-care-for-patients-with-diabetes-and-mulitmorbidity-registered-at-nurse-practitioner-led-clinics
#19
Roberta Heale, Elizabeth Wenghofer, Susan James, Marie-Luce Garceau
Background Nurse Practitioner-Led Clinics are a new model of primary healthcare in Ontario. Nurse Practitioner-Led Clinics are distinctive in that nurse practitioners are the primary care providers working with an interprofessional team. There have been no evaluations of the quality of care within the Nurse Practitioner-Led Clinic model. Purpose Evaluation of the Nurse Practitioner-Led Clinic model, specifically for complex clinical presentations, will provide insights that may be used to inform improvements to the delivery of care in the Nurse Practitioner-Led Clinics...
January 1, 2017: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
https://www.readbyqxmd.com/read/29206262/sbirt-education-for-nurse-practitioner-students-integration-into-an-msn-program
#20
Jeanne Moore, Petra Goodman, Janet Selway, Elizabeth Hawkins-Walsh, Janet Merritt, Jill Dombrowski
BACKGROUND: Substance use disorders are a major public health problem. As primary care providers, nurse practitioners (NPs) must be proficient at screening, identifying, and intervening for at-risk patients. Screening, brief intervention, and referral to treatment (SBIRT) is a well-established, evidence-based model for teaching behavioral health skills to health care providers. It is vital that Master of Science in Nursing (MSN)-NP programs incorporate SBIRT into their curricula. METHOD: SBIRT content was mapped to 10 courses across an MSN-NP program...
December 1, 2017: Journal of Nursing Education
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