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Primary care residency

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https://www.readbyqxmd.com/read/28350833/a-fast-and-frugal-algorithm-to-strengthen-diagnosis-and-treatment-decisions-for-catheter-associated-bacteriuria
#1
Aanand D Naik, Felicia Skelton, Amber B Amspoker, Russell A Glasgow, Barbara W Trautner
OBJECTIVES: Guidelines for managing catheter-associated urinary tract infection (CAUTI) and asymptomatic bacteria (ASB) are poorly translated into routine care due in part to cognitive diagnostic errors. This study determines if the accuracy for CAUTI and ASB diagnosis and treatment improves after implementation of a fast and frugal algorithm compared with traditional education methods. MATERIALS AND METHODS: A pre and post-intervention with contemporaneous comparison site involving inpatient and long term care wards at two regional Veterans Affairs Systems in United States...
2017: PloS One
https://www.readbyqxmd.com/read/28346626/preparing-residents-for-teaching-careers-the-faculty-for-tomorrow-resident-workshop
#2
Steven Lin, Paul Gordon
BACKGROUND AND OBJECTIVES: Progress toward growing the primary care workforce is at risk of being derailed by an emerging crisis: a critical shortage of family medicine faculty. In response to the faculty shortage, the Society of Teachers of Family Medicine (STFM) launched a 2-year initiative called "Faculty for Tomorrow" (F4T). The F4T Task Force created a workshop designed to increase residents' interest in, and prepare them for, careers in academic family medicine. We aimed to evaluate the effectiveness of this workshop...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28336363/does-surgical-teaching-take-time-resident-participation-in-minimally-invasive-hysterectomy-for-endometrial-cancer
#3
Alexandra H Freeman, Allison Barrie, Liisa Lyon, Carol Conell, Christine Garcia, Ramey D Littell, C Bethan Powell
STUDY OBJECTIVE: To determine the association between resident involvement and operative time for minimally invasive surgery (MIS) for endometrial cancer. DESIGN: Retrospective cohort study DESIGN: Classification: II-2 SETTING: Integrated health care system in Northern California PATIENTS: A total of 1,433 women who underwent MIS for endometrial cancer and endometrial intraepithelial neoplasia from January 2009 to January 2014. INTERVENTIONS: Resident participation in 430/688 laparoscopic cases (62%) and 341/745 robotic cases (46%)...
March 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28335809/poor-uptake-of-an-online-intervention-in-a-cluster-randomised-controlled-trial-of-online-diabetes-education-for-rural-general-practitioners
#4
Christine L Paul, Leon Piterman, Jonathan E Shaw, Catherine Kirby, Kristy L Forshaw, Jennifer Robinson, Isaraporn Thepwongsa, Robert W Sanson-Fisher
BACKGROUND: In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control...
March 23, 2017: Trials
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#5
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333613/collaborative-management-of-neurocognitive-disorders-in-primary-care-explorations-of-an-attempt-at-culture-change
#6
Lewis Mehl-Madrona, Barbara Mainguy
INTRODUCTION: Minor neurocognitive disorder (MiND; previously mild cognitive impairment) is a transitional zone between normal cognitive function and early stages of major neurocognitive disorder (previously called dementia). Of people with MiND, 5% to 10% progress to major neurocognitive disorder. Simple interventions such as memory activities, balance exercises, and anti-inflammatory diets have been shown to improve cognitive ability. Also, education and support in group settings have proved beneficial for patients with MiND...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28333519/-doctor-are-you-listening-communication-about-children-s-mental-health-and-psychosocial-concerns
#7
Anne E Pidano, Madhavi M Padukkavidana, Lisa Honigfeld
Effective communication is critical, including in the pediatric primary care setting. Pediatric primary care providers (PPCPs) are in a unique position to address psychosocial and mental health concerns during office visits, and effective communication skills play a crucial role in providing an opportunity for parents and patients to disclose and discuss such concerns. In this article, the authors encourage two relatively simple strategies that have shown potential for enhancing effective communication in pediatric primary care regarding mental health and psychosocial issues: (a) ensure that pediatric residents and practicing providers have access to brief, targeted communications training and (b) strongly promote the use of screening tools both to encourage discussion and to assist in identifying children who may benefit from further assessment and/or treatment...
March 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28331296/lay-health-educators-within-primary-care-practices-to-improve-cancer-screening-uptake-for-south-asian-patients-challenges-in-quality-improvement
#8
A K Lofters, M Vahabi, V Prakash, L Banerjee, P Bansal, S Goel, S Dunn
BACKGROUND: Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach. MATERIALS AND METHODS: Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28330941/nurse-driven-clinical-pathway-for-inpatient-asthma-a-randomized-controlled-trial
#9
Catherine M Pound, Victoria Gelt, Salwa Akiki, Kaylee Eady, Katherine Moreau, Franco Momoli, Barbara Murchison, Roger Zemek, Brett Mulholland, Tom Kovesi
OBJECTIVE: We examined the impact of a nurse-driven clinical pathway on length of stay (LOS) for children hospitalized with asthma. METHODS: We conducted a randomized controlled trial involving children hospitalized with asthma. Nurses of children in the intervention group weaned salbutamol frequency using an asthma scoring tool, whereas physicians weaned salbutamol frequency for the control group patients as per standard care. The primary outcome was LOS in hours...
March 22, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28329631/the-burden-of-keratinocyte-cancer-occurrence-multiplicity-and-predicting-risk
#10
David C Whiteman, Nirmala Pandeya, Bridie Thompson, Padmini Subramaniam, Jean Claude Dusingize, Rachel E Neale, Adele C Green, Catherine M Olsen
The costs of diagnosing and treating basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) are the highest of all cancers in Australia. However, information regarding incidence, multiplicity and risk are scarce as keratinocyte cancers (KCs) are not captured by most registries. To address these gaps, we initiated the QSKIN Study in 2010 recruiting 43,794 Queensland residents from a population register (participation 24%). Participants self-completed a baseline survey recording information on residential history, sun exposure, phenotype and medical and family history...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28323854/the-unfinished-health-agenda-neonatal-mortality-in-cambodia
#11
Rathmony Hong, Pauline Yongeun Ahn, Frank Wieringa, Tung Rathavy, Ludovic Gauthier, Rathavuth Hong, Arnaud Laillou, Judit Van Geystelen, Jacques Berger, Etienne Poirot
BACKGROUND: Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries...
2017: PloS One
https://www.readbyqxmd.com/read/28323324/preventing-hospitalization-with-veterans-affairs-home-based-primary-care-which-individuals-benefit-most
#12
Samuel T Edwards, Somnath Saha, Julia C Prentice, Steven D Pizer
OBJECTIVES: To examine how medical complexity modifies the relationship between enrollment in Department of Veterans Affairs (VA) home-based primary care (HBPC) and hospitalization for ambulatory care-sensitive conditions (ACSC) for veterans with diabetes mellitus and whether the effect of HBPC on hospitalizations varies according to clinical condition. DESIGN: Retrospective cohort study. SETTING: VA and non-VA hospitals. PARTICIPANTS: VA beneficiaries aged 67 and older with diabetes mellitus and enrolled in Medicare (N = 364,972)...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28319988/travel-distance-to-cancer-treatment-facilities-in-the-deep-south
#13
Mary J Wills, Marilyn V Whitman, Thomas M English
Despite ongoing efforts to improve rural healthcare, the health problems facing rural communities persist. The lack of healthcare providers and infrastructure in rural areas has been linked to a number of negative consequences. Among the elderly rural population, the lack of proximal access presents greater barriers because many elderly people are further limited in their ability to travel and pay for services. In the Deep South specifically, rural residents experience limited access to care and overall poor health outcomes...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28315478/improving-palliative-care-through-teamwork-impactt-in-nursing-homes-study-design-and-baseline-findings
#14
Helena Temkin-Greener, Susan Ladwig, Zhiqiu Ye, Sally A Norton, Dana B Mukamel
BACKGROUND: The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life...
March 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28306323/a-feasibility-assessment-of-behavioral-based-interviewing-to-improve-candidate-selection-for-a-pulmonary-and-critical-care-medicine-fellowship-program
#15
Geneva Tatem, Maria Kokas, Cathy L Smith, Bruno DiGiovine
Traditional interviews for residency and fellowship training programs are an important component in the selection process, but can be of variable value due to a non-standardized approach. We redesigned the candidate interview process for our large pulmonary and critical care medicine fellowship program in the United States using a behavioral-based interview structure. The primary goal of this approach was to standardize the assessment of candidates within non-cognitive domains with the goal of selecting those with the best fit for our institution's fellowship program...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28304182/insurance-reimbursement-for-complementary-healthcare-services
#16
James Whedon, Tor D Tosteson, Anupama Kizhakkeveettil, Melissa Nagare Kimura
INTRODUCTION: Insurance reimbursement for clinical services provided by complementary healthcare professionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financially accessible to all who may need or want these services. The purpose of this project was to evaluate the likelihood of insurance reimbursement for complementary healthcare services compared with other complementary services and with conventional primary care medical services in New Hampshire...
March 17, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28300986/primary-health-care-quality-in-rocinha-rio-de-janeiro-brazil-from-the-perspective-of-children-caregivers-and-adult-users
#17
Luiz Felipe Pinto, Erno Harzheim, Lisiane Hauser, Otávio Pereira D'Avila, Marcelo Rodrigues Gonçalves, Paula Travassos, Renan Pessanha
This paper aims to evaluate the extent of PHC attributes, from the experience of users, both adults and children caregivers, comparing the area served by the health facilities of the district of Rocinha with other areas of health district 2.1 in the municipality of Rio de Janeiro. The measuring tool used to evaluate the quality of services provided was the Primary Care Assessment Tools. A cross-sectional study was conducted, with independent random samples and 802 interviewees. Results indicate a better performance for children care when compared to adult care...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300983/preceptorship-in-family-and-community-medicine-challenges-and-achievements-in-a-primary-health-care-in-progress
#18
Mellina Marques Vieira Izecksohn, Jorge Esteves Teixeira, Bruno Pereira Stelet, Adelson Guaraci Jantsch
Strengthening Primary Health Care (PHC) relies directly on training medical specialists in primary care. This text aims to report the Family Medicine training experiences in Rio de Janeiro between 2008 and 2016. It brings to reflection the development of preceptors in medical specialization through an experience report on three Family Medicine medical residency programs, namely, the Municipal Health Secretariat program, the Federal University of Rio de Janeiro program and the National School of Public Health program...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300018/changes-in-social-engagement-and-depression-predict-incident-loneliness-among-seriously-ill-home-care-clients
#19
Samantha Fernandes, Jacob G S Davidson, Dawn M Guthrie
OBJECTIVE: This study identified the predictors of incident loneliness in a group of seriously ill older adults (aged 65+) receiving home care. METHOD: Existing data collected with the Resident Assessment Instrument for Home Care (RAI-HC) were utilized. A cohort of clients (N = 2,499) with two RAI-HC assessments and no self-reported loneliness at time 1 were included. Self-reported loneliness, upon reassessment, was the outcome of interest. Clients with a prognosis of less than six months or severe health instability were included...
March 16, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28296989/premature-mortality-among-patients-recently-discharged-from-their-first-inpatient-psychiatric-treatment
#20
Florian Walter, Matthew J Carr, Pearl L H Mok, Aske Astrup, Sussie Antonsen, Carsten B Pedersen, Jenny Shaw, Roger T Webb
Importance: Nationwide cohorts provide sufficient statistical power for examining premature, cause-specific mortality in patients recently discharged from inpatient psychiatric services. Objective: To investigate premature mortality in a nationwide cohort of patients recently discharged from inpatient psychiatric treatment at ages 15 to 44 years. Design, Setting, and Participants: This single-cohort design included all persons born in Denmark (N = 1 683 385) between January 1, 1967, and December 31, 1996...
March 15, 2017: JAMA Psychiatry
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