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https://www.readbyqxmd.com/read/28538499/expectations-and-experiences-of-follow-up-and-self-care-after-living-kidney-donation-a-focus-group-study
#1
Karine E Manera, Camilla S Hanson, Jeremy R Chapman, John Kanellis, John Gill, Jonathan C Craig, Steve J Chadban, Germaine Wong, Angelique F Ralph, Allison Tong
BACKGROUND: Ensuring donor wellbeing warrants ongoing monitoring following living kidney donation. However, there is considerable variability in donor follow up processes, including information provided to donors regarding self-care. Loss to follow up is common, suggesting that the aims and benefits of monitoring and follow up may not be apparent. We aimed to describe the experiences and expectations of living kidney donors regarding follow up and self-care after donation. METHODS: Participants from 3 transplant centers in Australia and Canada participated in 14 focus groups (n=123)...
May 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28535315/early-career-outcomes-of-family-medicine-residency-graduates-exposed-to-innovative-flexible-longitudinal-tracks
#2
Richard A Young, Dan Casey, Diana Singer, Elaine Waller, Patricia A Carney
BACKGROUND AND OBJECTIVES: The Preparing the Personal Physician for Practice (P4) project used a case series design to study innovations in the content, length, structure, and location of residency training in 14 geographically diverse family medicine programs between 2007 and 2012. We aimed to explore how offering flexible longitudinal tracks (FLT) affected graduates' scope of practice, particularly in maternal child health (MCH), which included at least 17 months of focused training that increased each year over 4 years...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#3
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#4
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28526974/the-health-equity-scholars-program-innovation-in-the-leaky-pipeline
#5
Carole C Upshur, Diedra M Wrighting, Gonzalo Bacigalupe, Joan Becker, Laura Hayman, Barbara Lewis, Sylvia Mignon, Megan E Rokop, Elizabeth Sweet, Marie Idali Torres, Paul Watanabe, Cedric Woods
Despite attempts to increase enrollment of under-represented minorities (URMs: primarily Black/African American, Hispanic/Latino, and Native American students) in health professional programs, limited progress has been made. Compelling reasons to rectify this situation include equity for URMs, better prepared health professionals when programs are diverse, better quality and access to health care for UMR populations, and the need for diverse talent to tackle difficult questions in health science and health care delivery...
May 19, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28526836/characterisation-of-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-danish-general-practice-a-retrospective-registry-based-cohort-study
#6
Rune Aabenhus, Malene Plejdrup Hansen, Laura Trolle Saust, Lars Bjerrum
Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice...
May 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#7
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/28511195/safety-aspects-of-postanesthesia-care-unit-discharge-without-motor-function-assessment-after-spinal-anesthesia-a-randomized-multicenter-semiblinded-noninferiority-controlled-trial
#8
Eske Kvanner Aasvang, Christoffer Calov Jørgensen, Mogens Berg Laursen, Jacob Madsen, Søren Solgaard, Mogens Krøigaard, Per Kjærsgaard-Andersen, Hans Mandøe, Torben Bæk Hansen, Jørgen Ulrich Nielsen, Niels Krarup, Annette Elisabeth Skøtt, Henrik Kehlet
BACKGROUND: Postanesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to allow clinical recommendations. METHODS: A multicenter, semiblinded, noninferiority randomized controlled trial of discharge from the PACU with or without assessment of lower limb motor function after elective total hip or knee arthroplasty under spinal anesthesia was undertaken...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28508237/development-of-a-unifying-target-and-consensus-indicators-for-global-surgical-systems-strengthening-proposed-by-the-global-alliance-for-surgery-obstetric-trauma-and-anaesthesia-care-the-g4-alliance
#9
REVIEW
Adil Haider, John W Scott, Colin D Gause, Mira Meheš, Grace Hsiung, Albulena Prelvukaj, Dana Yanocha, Lauren M Baumann, Faheem Ahmed, Na'eem Ahmed, Sara Anderson, Herve Angate, Lisa Arfaa, Horacio Asbun, Tigistu Ashengo, Kisembo Asuman, Ruben Ayala, Stephen Bickler, Saul Billingsley, Peter Bird, Matthijs Botman, Marilyn Butler, Jo Buyske, Angelo Capozzi, Kathleen Casey, Charles Clayton, James Cobey, Michael Cotton, Dan Decklebaum, Milliard Derbew, Catherine deVries, Jeanne Dillner, Max Downham, Natalie Draisin, David Echinard, Sohier Elneil, Ahmed ElSayed, Abigail Estelle, Allen Finley, Erica Frenkel, Philip K Frykman, Florin Gheorghe, Julian Gore-Booth, Richard Henker, Jaymie Henry, Orion Henry, Laura Hoemeke, David Hoffman, Iko Ibanga, Eric V Jackson, Pankaj Jani, Walter Johnson, Andrew Jones, Zeina Kassem, Asuman Kisembo, Abbey Kocan, Sanjay Krishnaswami, Robert Lane, Asad Latif, Barbara Levy, Dimitrios Linos, Peter Linz, Louis A Listwa, Declan Magee, Emmanuel Makasa, Michael L Marin, Claude Martin, Kelly McQueen, Jaime Morgan, Richard Moser, Robert Neighbor, William M Novick, Stephen Ogendo, Akinyinka Omigbodun, Bisola Onajin-Obembe, Neil Parsan, Beverly K Philip, Raymond Price, Shahnawaz Rasheed, Marjorie Ratel, Cheri Reynolds, Steven M Roser, Jackie Rowles, Lubna Samad, John Sampson, Harshadkumar Sanghvi, Marchelle L Sellers, David Sigalet, Bruce C Steffes, Erin Stieber, Mamta Swaroop, John Tarpley, Asha Varghese, Julie Varughese, Richard Wagner, Benjamin Warf, Neil Wetzig, Susan Williamson, Joshua Wood, Anne Zeidan, Lewis Zirkle, Brendan Allen, Fizan Abdullah
After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28506954/epxmedtracking-feasibility-evaluation-of-an-sms-based-medication-adherence-tracking-system-in-community-practice
#10
Christopher Tricarico, Robert Peters, Avik Som, Kavon Javaherian, Will Ross
BACKGROUND: Medication adherence remains a difficult problem to both assess and improve in patients. It is a multifactorial problem that goes beyond the commonly cited reason of forgetfulness. To date, eHealth (also known as mHealth and telehealth) interventions to improve medication adherence have largely been successful in improving adherence. However, interventions to date have used time- and cost-intensive strategies or focused solely on medication reminding, leaving much room for improvement in using a modality as flexible as eHealth...
May 15, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28499364/clinical-classification-in-low-back-pain-best-evidence-diagnostic-rules-based-on-systematic-reviews
#11
Tom Petersen, Mark Laslett, Carsten Juhl
BACKGROUND: Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization...
May 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28494333/implementing-monitoring-technologies-in-care-homes-for-people-with-dementia-a-qualitative-exploration-using-normalization-process-theory
#12
Alex Hall, Christine Brown Wilson, Emma Stanmore, Chris Todd
BACKGROUND: Ageing societies and a rising prevalence of dementia are associated with increasing demand for care home places. Monitoring technologies (e.g. bed-monitoring systems; wearable location-tracking devices) are appealing to care homes as they may enhance safety, increase resident freedom, and reduce staff burden. However, there are ethical concerns about the use of such technologies, and it is unclear how they might be implemented to deliver their full range of potential benefits...
April 27, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28491307/better-sooner-more-convenient-the-reality-of-pursuing-greater-integration-between-primary-and-secondary-healthcare-providers-in-new-zealand
#13
Kirsten Lovelock, Greg Martin, Robin Gauld, Jayden MacRae
OBJECTIVES: This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28480674/using-israel-s-national-cancer-registry-database-to-track-progress-in-the-war-against-cancer-a-challenge-for-health-services
#14
Eliezer Robinson, Barbara G Silverman, Lital Keinan-Boker
BACKGROUND: The number of cancer survivors has been increasing worldwide and is now approximately 32.6 million and growing. Cancer survivors present a challenge to health care providers because of their higher susceptibility to long-term health outcomes related to their primary disease and treatment. OBJECTIVES: To report on the number of cancer survivors and incident cancer cases in the period 1960-2009 in Israel, in order to provide data on the scope of the challenge Israel's health care funds face...
April 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28477230/a-matched-case-control-comparison-of-hospital-costs-and-outcomes-for-knee-replacement-patients-admitted-postoperatively-to-acute-care-versus-rehabilitation
#15
Brian K Tse, Tessa L Walters, Steven K Howard, T Edward Kim, Stavros G Memtsoudis, Eric C Sun, Alex Kou, Lorrie Graham, Robert King, Edward R Mariano
For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward...
May 5, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28476101/community-based-randomized-controlled-trial-of-diabetes-prevention-study-for-high-risk-individuals-of-type-2-diabetes-lifestyle-intervention-using-web-based-system
#16
Seon-Ah Cha, Sun-Young Lim, Kook-Rye Kim, Eun-Young Lee, Borami Kang, Yoon-Hee Choi, Kun-Ho Yoon, Yu-Bae Ahn, Jin-Hee Lee, Seung-Hyun Ko
BACKGROUND: The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM). METHODS/DESIGN: The community-based Korean Diabetes Prevention Study (C-KDPS) is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months...
May 5, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28474361/iconnect-ckd-virtual-medical-consulting-a-web-based-chronic-kidney-disease-hypertension-and-diabetes-integrated-care-program
#17
Ivor J Katz, Saiyini Pirabhahar, Paula Williamson, Vishwas Raghunath, Frank Brennan, Anthony O'Sullivan, George Youssef, Cathie Lane, Gary Jacobson, Peter Feldman, John Kelly
AIMS: Chronic kidney disease (CKD) patients overwhelm specialist services and can potentially be managed in the primary care (PC). Opportunistic screening of high risk (HR) patients and follow-up in PC is the most sustainable model of care. A 'virtual consultation' (VC) model instead of traditional face to face (F2F) consultations was used, aiming to assess efficacy and safety of the model. METHODS: Seventy patients were recruited from PC sites and hospital clinics, and followed for one year...
May 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28471436/a-novel-approach-in-pediatric-telegenetic-services-geneticist-pediatrician-and-genetic-counselor-team
#18
Shobana Kubendran, Siddharthan Sivamurthy, Gerald Bradley Schaefer
PurposeOur aim was to improve access to genetic services in an underserved region by developing a collaborative telegenetic service delivery model with a pediatrician, medical geneticist, and genetics counselor (GC).MethodsProtocols for the evaluation of common genetic indications were developed. Patients referred with indications suggestive of a syndromic etiology were scheduled to see the geneticist directly via telegenetics. Other patients were scheduled to see the pediatrician and GC in person before follow-up with the geneticist if indicated...
May 4, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28465122/authentication-of-radial-versus-femoral-arterial-pressure-waveform-derived-cardiac-output-with-transesophageal-echocardiography-derived-cardiac-output-measurements-in-patients-undergoing-on-pump-coronary-bypass-surgery
#19
Madan Mohan Maddali, Niranjan Dilip Waje, Panchatcharam Murthi Sathiya
OBJECTIVE: The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28459895/management-of-bow-legs-in-children-a-primary-care-protocol
#20
Samuel Dettling, Dennis S Weiner
Objective: To reduce unnecessary orthopedic referrals by developing a protocol for managing physiologic bow legs in the primary care environment through the use of a noninvasive technique that simultaneously tracks normal varus progression and screens for potential pathologic bowing requiring an orthopedic referral. Methods: Retrospective study of 155 patients with physiologic genu varum and 10 with infantile Blount`s disease. We used fingerbreadth measurements to document progression or resolution of bow legs...
May 2017: Journal of Family Practice
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