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Primary care residency

Shanna Cheng, Elton Li, Anna S Lok
Despite guidelines recommending hepatitis B virus (HBV) screening among the Asian population, not all Asians are screened. We assessed barriers to and factors predicting HBV screening in Michigan. Adults residing in Southeast Michigan self-identifying as Asian were surveyed at Asian grocery stores, restaurants, churches, and community events. 404 persons participated in the survey, 54 % were women, median age was 51 years, 63 % were Chinese, and 93.8 % were born outside the U.S. 181 (44.8 %) had not or could not recall having been screened for HBV...
October 21, 2016: Journal of Community Health
Kathleen Falster, Emily Banks, Sanja Lujic, Michael Falster, John Lynch, Karen Zwi, Sandra Eades, Alastair H Leyland, Louisa Jorm
BACKGROUND: Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. METHODS: This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children...
October 21, 2016: BMC Pediatrics
Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
Annie L Nguyen, Tingjian Yan, Kathleen Ell, Jorge Gonzalez, Susan Enguidanos
OBJECTIVE: Latinos are disproportionately affected by diabetes and people with diabetes experience frequent hospital admissions and readmissions. Care transition interventions can help reduce rates of readmission; however, there are many barriers to recruiting Latinos for participation in intervention research. Exploring reasons for study refusal furthers understanding of low research participation rates to help researchers address barriers. DESIGN: This study presents a cross-sectional, descriptive analysis of reasons for study refusal and attrition drawing from data collected as part of a randomized controlled trial conducted to test the effectiveness of a transitions intervention for diabetic Latino discharged from the hospital to home...
October 21, 2016: Ethnicity & Health
Crystal S Y Cheung, Nima Noordeh, Chloe C Gottlieb
BACKGROUND: The objectives of this study are to assess Canadian ophthalmologists' awareness of established uveitis treatment guidelines and clinical management of uveitis and to assess the frequency of government applications for immunomodulatory therapy (IMT) and identify primary prescribers. A 25-item questionnaire was sent to 759 practicing Canadian ophthalmologists. Six questions assessed demographics including the year of residency completion, training by uveitis specialists during residency, and fellowship training...
December 2016: Journal of Ophthalmic Inflammation and Infection
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Kristin M Berg, Stevens S Smith, Jessica W Cook, Michael C Fiore, Douglas E Jorenby
While women Veterans have a higher prevalence of smoking than civilian women, little is known about their quitting behavior. Via a chart review, we characterized referral and enrollment patterns in tobacco cessation services (TCS), and quit attempts among 366 women Veteran smokers at a Midwestern Veterans Hospital. Cases receiving referrals to TCS (n = 183) were matched 1:1 to controls who did not (n = 183), by year of referral. Variables included age, marital status, urbanicity, smoking status, comorbidities, pregnancy, packs per day, number of prior smoking cessation medications, provider gender, provider type, and clinical location of referral placement...
October 2016: Military Medicine
Nicholas S Sigona, Jeffrey M Steele, Christopher D Miller
OBJECTIVES: To determine the impact of a pharmacist-driven beta-lactam allergy interview on antimicrobial therapy. SETTING: Tertiary care academic medical center. PRACTICE SETTING: Clarification of beta-lactam allergy may expand treatment options for patients and potentially improve outcomes, reduce toxicity, and reduce costs. PRACTICE INNOVATION: At our institution, a pilot service using a pharmacy resident and infectious diseases clinical pharmacist was implemented to clarify beta-lactam allergy information and, where appropriate, recommend a change to the patient's antibiotic therapy...
October 8, 2016: Journal of the American Pharmacists Association: JAPhA
Mandira Paul, Sharad D Iyengar, Birgitta Essén, Kristina Gemzell-Danielsson, Kirti Iyengar, Johan Bring, Marie Klingberg-Allvin
BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion...
October 17, 2016: BMC Public Health
Clara Cavero-Carbonell, Silvia Gimeno-Martos, Lucía Páramo-Rodríguez, María José Rabanaque-Hernández, Carmen Martos-Jiménez, Óscar Zurriaga
BACKGROUND: Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades. OBJECTIVE: To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women residents in the Valencia Region. METHODS: A case-control study, considering a case as a less than one year old live birth in 2009-2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry...
October 13, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Judith Lauren Chasin
No abstract text is available yet for this article.
October 11, 2016: Journal of General Internal Medicine
Ahmad Elnahas, Timothy D Jackson, Allan Okrainec, Peter C Austin, Chaim M Bell, David R Urbach
BACKGROUND: In 2009, the Ontario Bariatric Network was established to address the exploding demand by Ontario residents for bariatric surgery services outside Canada. We compared the use of postoperative hospital services between out-of-country surgery recipients and patients within the Ontario Bariatric Network. METHODS: We conducted a population-based, comparative study using administrative data held at the Institute for Clinical Evaluative Sciences. We included Ontario residents who underwent bariatric surgery between 2007 and 2012 either outside the country or at one of the Ontario Bariatric Network's designated centres of excellence...
July 2016: CMAJ Open
Carolyn Wong, David B Hogan
BACKGROUND: A common scenario that may pose challenges to primary care providers is when an older patient has been discharged from hospital. The aim of this pilot project is to examine the experiences of patients' admission to hospital through to discharge back home, using analysis of patient narratives to inform the strengths and weaknesses of the process. METHODS: For this qualitative study, we interviewed eight subjects from the Sheldon M. Chumir Central Teaching Clinic (CTC)...
September 2016: Canadian Geriatrics Journal: CGJ
Mariusz Dąbrowski, Elektra Szymańska-Garbacz, Zofia Miszczyszyn, Tadeusz Dereziński, Leszek Czupryniak
BACKGROUND: The risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancer - difficult within regular outpatient diabetes care - is of utmost importance for patients' survival. The aim of this multicenter, retrospective (years 1998-2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting. METHODS: In the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified...
October 10, 2016: BMC Cancer
Craig Evan Pollack, Michelle E Ross, Katrina Armstrong, Charles C Branas, Karin V Rhodes, Justin E Bekelman, Alicia Wentz, Christian Stillson, Archana Radhakrishnan, Enny Oyeniran, David Grande
PURPOSE: Prior work suggests that access to health care may influence the diagnosis and treatment of prostate cancer. Mystery-caller methods have been used previously to measure access to care for health services such as primary care, where patients' self-initiate requests for care. We used a mystery-caller survey for specialized prostate cancer care to assess dimensions of access to prostate cancer care. MATERIALS AND METHODS: We created an inventory of urology and radiation oncology practices in southeastern Pennsylvania...
2016: PloS One
Bonnie L Green, Pamela A Saunders, Elizabeth Power, Priscilla Dass-Brailsford, Kavitha Bhat Schelbert, Esther Giller, Larry Wissow, Alejandra Hurtado de Mendoza, Mihriye Mete
Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment...
2016: Journal of Loss & Trauma
Ugochukwu U Onyeonoro, Okechukwu S Ogah, Andrew U Ukegbu, Innocent I Chukwuonye, Okechukwu O Madukwe, Akhimiem O Moses
BACKGROUND: Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. METHODS: This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above...
2016: Health Services Insights
S M Crawford, J Skinner, E Coombes, A P Jones
AIM: A potential impact of the centralisation of cancer services in the UK is difficulty in gaining access for members of the population living far from them. This could lead to delayed presentation of cancer with more advanced disease and clinical deterioration at diagnosis. A patient may be recorded in the cancer registry as having cancer of unknown primary (CUP) if the clinical state at presentation precludes investigation. Other patients may be so recorded if investigation identifies sites of metastatic tumour but the primary is not found...
October 5, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Mustafa Hussein, Ana V Diez Roux, Robert I Field
Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics)...
October 7, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Shreya Kangovi, Nandita Mitra, Robyn A Smith, Raina Kulkarni, Lindsey Turr, Hairong Huo, Karen Glanz, David Grande, Judith A Long
OBJECTIVE: Growing interest in collaborative goal-setting has raised questions. First, are patients making the 'right choices' from a biomedical perspective? Second, are patients and providers setting goals of appropriate difficulty? Finally, what types of support will patients need to accomplish their goals? We analyzed goals and action plans from a trial of collaborative goal-setting among 302 residents of a high-poverty urban region who had multiple chronic conditions. METHODS: Patients used a low-literacy aid to prioritize one of their chronic conditions and then set a goal for that condition with their primary care provider...
September 25, 2016: Patient Education and Counseling
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