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https://www.readbyqxmd.com/read/29350791/comparison-of-outpatient-medically-attended-and-community-level-influenza-like-illness-new-york-city-2013-2015
#1
Kate E Russell, Ashley Fowlkes, Melissa S Stockwell, Celibell Y Vargas, Lisa Saiman, Elaine L Larson, Philip LaRussa, Steve Di Lonardo, Michael Popowich, Kirsten St George, Andrea Steffens, Carrie Reed
BACKGROUND: Surveillance of influenza-like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non-medically attended ILI. OBJECTIVES: To assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for Disease Control and Prevention Influenza Incidence Surveillance Project (IISP) and the Mobile Surveillance for Acute Respiratory Infections (ARI) and Influenza-Like Illness in the Community (MoSAIC) Study...
January 19, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29350325/evaluation-and-management-of-rotator-cuff-tears-a-primary-care-perspective
#2
REVIEW
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29347834/acute-care-use-for-ambulatory-care-sensitive-conditions-in-high-cost-users-of-medical-care-with-mental-illness-and-addictions
#3
Jennifer M Hensel, Valerie H Taylor, Kinwah Fung, Rebecca Yang, Simone N Vigod
OBJECTIVE: The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care. METHOD: A retrospective, population-based cohort study using data from Ontario, Canada...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#4
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#5
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29338743/the-prospective-and-concurrent-effect-of-exercise-on-health-related-quality-of-life-in-older-adults-over-a-3%C3%A2-year-period
#6
Helen-Maria Vasiliadis, Mathieu F Bélanger
BACKGROUND: It is not clear whether socioeconomic status influences health outcomes among older adults through its effect on physical activity. The aim of this study was to assess the effect of sex and neighborhood socio-economic status on the change in health related quality of life (HR-QOL) as a function of physical activity over a three-year period. METHODS: This cohort study included French-speaking community-dwelling older adults recruited in primary care practices in the province of Quebec and participating in the 'Étude sur la Santé des Ainés' (ESA)-Services study on the health of the elderly...
January 16, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29337041/provision-of-abortion-and-other-reproductive-health-services-among-former-midwest-access-project-trainees
#7
Debra B Stulberg, Kristie Monast, Irma H Dahlquist, Kate Palmer
OBJECTIVE: The Midwest Access Project (MAP) offers opt-in training to students, residents, and practicing clinicians in reproductive healthcare including abortion. We surveyed MAP alumni to identify current practice characteristics and assess predictors of reproductive health service provision. STUDY DESIGN: We sent an online survey to alumni of MAP's Individual Clinical Training program, 2007-2015 (n=127). The primary outcome was current provision of any abortion service...
January 11, 2018: Contraception
https://www.readbyqxmd.com/read/29336277/evaluation-of-hypoglycemia-and-potential-risk-factors-in-a-veterans-affairs-community-living-center
#8
Marissa L Ostroff, Kristin Aloi, William Bryan, Jason Moss, Lindsay Garris, Richard Sloane, Jennie Hewitt, Carrie Thomas, Janine Bailey
OBJECTIVES: To describe hypoglycemic events in a Veterans Affairs (VA) community living center (CLC) population and to determine predictive risk factors associated with hypoglycemia. DESIGN: Retrospective, exploratory, observational chart review. SETTING: Tertiary-care VA Healthcare System CLC. PATIENTS: Residents residing in a VA CLC with at least one active order for insulin between June 1, 2009, and June 30, 2013, were evaluated over a 90-day study period...
January 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29335101/outcomes-and-complication-rates-of-primary-resident-performed-cataract-surgeries-at-a-large-tertiary-care-county-hospital
#9
Cameron Clarke, Shazia F Ali, Michael Murri, Saagar N Patel, Li Wang, Marie Tuft, Mitchell P Weikert, Zaina Al-Mohtaseb
PURPOSE: To identify the preoperative risk factors, intraoperative events, and postoperative complications increasing the risk for poor visual outcomes in resident-performed cataract surgeries at a tertiary-care county hospital. SETTING: Ben Taub General Hospital, Houston, Texas, USA. DESIGN: Retrospective case series. METHODS: Resident-performed cataract surgeries were analyzed for risk factors, comorbidities, and intraoperative and postoperative complications...
December 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29334912/estimating-the-total-prevalence-and-incidence-of-end-stage-kidney-disease-among-aboriginal-and-non-aboriginal-populations-in-the-northern-territory-of-australia-using-multiple-data-sources
#10
Lin Li, Steven Guthridge, Shu Qin Li, Yuejen Zhao, Paul Lawton, Alan Cass
BACKGROUND: Most estimates for End Stage Kidney Disease (ESKD) prevalence and incidence are based on renal replacement therapy (RRT) registers. However, not all people with ESKD will commence RRT and estimates based only on RRT registry data will underestimate the true burden of ESKD in the community. This study estimates the total number of Northern Territory (NT) residents with ESKD including: those receiving RRT, those diagnosed but not receiving RRT and an estimate of "undiagnosed" cases...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29333660/interventions-to-increase-attendance-for-diabetic-retinopathy-screening
#11
REVIEW
John G Lawrenson, Ella Graham-Rowe, Fabiana Lorencatto, Jennifer Burr, Catey Bunce, Jillian J Francis, Patricia Aluko, Stephen Rice, Luke Vale, Tunde Peto, Justin Presseau, Noah Ivers, Jeremy M Grimshaw
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness...
January 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29333106/which-point-of-care-tests-would-be-most-beneficial-to-add-to-clinical-practice-findings-from-a-survey-of-3-family-medicine-clinics-in-the-united-states
#12
Victoria Hardy, William Alto, Gina A Keppel, Laura-Mae Baldwin, Matthew Thompson
Background: Point-of-care tests (POCTs) are increasingly used in family medicine to facilitate screening, diagnosis, monitoring, treatment, and referral decisions for a variety of conditions. Point-of-care tests that clinicians believe might be beneficial to add to clinical practice and the conditions for which they would be most useful in family medicine remain poorly understood in the United States. Methods: Forty-two clinicians at 3 family medicine residency clinics completed a brief survey asking which POCTs they believed would be beneficial to add to their clinical practice and the conditions POCTs would be most useful for...
December 2017: Point of Care
https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#13
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#14
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329559/simplification-of-medications-prescribed-to-long-term-care-residents-simpler-study-protocol-for-a-cluster-randomised-controlled-trial
#15
Janet K Sluggett, Esa Y H Chen, Jenni Ilomäki, Megan Corlis, Sarah N Hilmer, Jan Van Emden, Choon Ean Ooi, Kim-Huong Nguyen, Tracy Comans, Michelle Hogan, Tessa Caporale, Susan Edwards, Lyntara Quirke, Allan Patching, J Simon Bell
BACKGROUND: Complex medication regimens are highly prevalent in residential aged care facilities (RACFs). Strategies to reduce unnecessary complexity may be valuable because complex medication regimens can be burdensome for residents and are costly in terms of nursing time. The aim of this study is to investigate application of a structured process to simplify medication administration in RACFs. METHODS: SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) is a non-blinded, matched-pair, cluster randomised controlled trial of a single multidisciplinary intervention to simplify medication regimens...
January 12, 2018: Trials
https://www.readbyqxmd.com/read/29320668/the-impact-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-on-anticoagulation-therapy-in-rural-australia
#16
Jamie W Bellinge, Jarrad J Paul, Liam S Walsh, Lokesh Garg, Gerald F Watts, Carl Schultz
OBJECTIVE: To determine the use of different anticoagulation therapies in rural Western Australia; to establish whether remoteness from health care services affects the choice of anticoagulation therapy; to gather preliminary data on anticoagulation therapy safety and efficacy. DESIGN: Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014-2015. SETTING: Four hospitals serving two-thirds of the rural population of Western Australia...
January 15, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29316598/s-orthopaedic-department-teaching-status-associated-with-adverse-outcomes-of-primary-total-knee-arthroplasty
#17
Dean C Perfetti, Nipun Sodhi, Anton Khlopas, Assem A Sultan, Suela Lamaj, Mathew R Boylan, Jared M Newman, Qais Naziri, William A Cantrell, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
INTRODUCTION: Although resident physicians have a critical role in the daily management of patients, based on their limited experiences, they are thought to potentially create inefficiencies in the hospital. With changes set forth by the Comprehensive Care for Joint Replacement (CJR) program, both teaching and non-teaching hospitals are directly compared on efficiency and outcomes. Therefore, the purpose of this study was to compare outcomes between teaching and non-teaching hospitals in the state of New York...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29313728/the-potential-of-currently-unavailable-herpes-virus-vaccines
#18
Július Rajcáni, Ferenc Bánáti, Kálmán Szenthe, Susan Szathmary
Despite overwhelming experimental work, there are no licensed vaccines against the most frequent Alphaherpesviruses, namely herpes simplex virus 1 and 2 (HSV1 and 2) nor against the Epstein-Barr virus (EBV), a member of the subfamily Gammaherpesvirus. Areas covered: Since the DNAs of both HSVs reside in the regional sensory ganglia in a latent state (i.e. as circularized episomal molecules), a corresponding vaccine might be useful for immunotherapy rather than prevention of primary infection. Here we describe the design of a purified subunit vaccine (a mix of at least 3 glycoproteins) as well as the preparation and efficacy of a recombinant fusion protein consisting of the gD ectodomain from our domestic attenuated HSV1 strain HSZP...
January 9, 2018: Expert Review of Vaccines
https://www.readbyqxmd.com/read/29311177/medical-students-views-of-medicine-as-a-calling-and-selection-of-a-primary-care-related-residency
#19
Audiey C Kao, Andrew J Jager
With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the "practice of medicine is a calling." Students who strongly agreed that medicine was a calling had higher odds (P=.003) of selecting a primary care-related residency...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29310606/ethnic-disparities-in-breast-cancer-survival-in-new-zealand-which-factors-contribute
#20
Sandar Tin Tin, J Mark Elwood, Charis Brown, Diana Sarfati, Ian Campbell, Nina Scott, Reena Ramsaroop, Sanjeewa Seneviratne, Vernon Harvey, Ross Lawrenson
BACKGROUND: New Zealand has major ethnic disparities in breast cancer survival with Māori (indigenous people) and Pacific women (immigrants or descended from immigrants from Pacific Islands) faring much worse than other ethnic groups. This paper identified underlying factors and assessed their relative contribution to this risk differential. METHODS: This study involved all women who were diagnosed with primary invasive breast cancer in two health regions, covering about 40% of the national population, between January 2000 and June 2014...
January 8, 2018: BMC Cancer
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