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Primary care residency

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https://www.readbyqxmd.com/read/28441678/the-addiction-recovery-clinic-a-novel-primary-care-based-approach-to-teaching-addiction-medicine
#1
Stephen R Holt, Nora Segar, Dana A Cavallo, Jeanette M Tetrault
PROBLEM: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. APPROACH: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#2
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441465/gender-differences-in-care-seeking-behavior-and-healthcare-consumption-immediately-after-whiplash-trauma
#3
Artur Tenenbaum, Lena Nordeman, Katharina S Sunnerhagen, Ronny Gunnarsson
OBJECTIVE: The aim was to study gender differences in care-seeking behavior and treatment provided immediately after whiplash trauma. METHODS: Participants were residents from a defined geographical area, Skaraborg County in the southwestern part of Sweden. A cohort of 3,368 persons exposed to whiplash trauma and attending a healthcare facility immediately after the trauma between 1999 and 2008 were identified in a database. Information about gender, age, time elapsed prior to seeking care, type of healthcare contact, initial treatment provided and eventual hospitalization time was retrieved...
2017: PloS One
https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#4
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28439360/psychiatry-residents-perceptions-and-reported-practices-in-providing-primary-care
#5
Lisa M Wehr, Erik R Vanderlip, Patrick H Gibbons, Jess G Fiedorowicz
BACKGROUND: Patients with psychiatric disorders have higher rates of chronic medical conditions and decreased life expectancy. Integrating medical and psychiatric care is likely to improve health outcomes for these patients. OBJECTIVE: This study examined what proportion of psychiatry residents viewed psychiatry as a primary care specialty, how important they felt it was to provide primary care to patients, and how this perception altered self-reported comfort and practice patterns in providing screening and treatment for select general medical conditions...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28434754/-patient-safety-culture-in-family-practice-residents-of-galicia
#6
Manuel Portela Romero, Rosendo Bugarín González, María Sol Rodríguez Calvo
OBJECTIVE: To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. DESIGN: A cross-sectional study. LOCATION: Seven FP of Galicia teaching units. PARTICIPANTS: 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. MEASUREMENTS: The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care...
April 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28432210/a-randomised-controlled-trial-of-a-complex-intervention-to-reduce-children-s-exposure-to-secondhand-smoke-in-the-home
#7
Elena Ratschen, Rebecca Thorley, Laura Jones, Magdalena Opazo Breton, Juliette Cook, Ann McNeill, John Britton, Tim Coleman, Sarah Lewis
OBJECTIVES: Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking. DESIGN: An open-label, parallel, randomised controlled trial. SETTING: Deprived communities in Nottingham City and County, England PARTICIPANTS: Caregivers resident in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home...
April 21, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28431532/residents-satisfaction-with-primary-medical-and-health-services-in-western-china
#8
Weinan Dong, Qingyu Zhang, Chunsheng Yan, Wanling Fu, Linlin Xu
BACKGROUND: Currently, China is in the process of medical and health care reform, and the establishment of primary medical and health services covering urban and rural residents is an important aspect of this process. Studying the satisfaction of residents of underdeveloped areas with their primary medical and health services and identifying the factors that can increase the satisfaction of different groups may improve patient compliance and ultimately improve health. Moreover, such research may provide a reference for the development of medical and health undertakings in similarly underdeveloped areas...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28430729/impact-of-distance-to-treatment-center-on-care-seeking-for-pelvic-floor-disorders
#9
Emily English, Lisa Rogo-Gupta
OBJECTIVE: The aim of this study was to evaluate the impact of distance from residence to treatment center on access to care for female pelvic floor disorders at an academic institution. METHODS: A retrospective cross-sectional study was conducted of women seen for pelvic floor disorders at an academic institution from 2008 to 2014. Patient characteristics were extracted from charts. Geographical and US census data was obtained from public records and used to calculate distance from patient residence to physician office...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28426310/a-public-health-approach-to-hepatitis-c-in-an-urban-setting
#10
Fabienne Laraque, Jay K Varma
The clinical consequences of HCV infection are increasing because the population with the highest prevalence of the infection, persons born between 1945 and 1965, is aging. As a result, health care expenditures are expected to increase. Now that a cure for HCV infection is the norm, a public health approach is necessary to identify, link to care, and treat infected persons and prevent new infections. We believe that the success of public health interventions, such as those for tuberculosis, can be translated to HCV infection...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28420324/evaluation-of-a-technology-enhanced-integrated-care-model-for-frail-older-persons-protocol-of-the-spec-study-a-stepped-wedge-cluster-randomized-trial-in-nursing-homes
#11
Hongsoo Kim, Yeon-Hwan Park, Young-Il Jung, Hyoungshim Choi, Seyune Lee, Gi-Soo Kim, Dong-Wook Yang, Myunghee Cho Paik, Tae-Jin Lee
BACKGROUND: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. METHODS/DESIGN: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate...
April 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28418280/twenty-first-century-pathologists-advocacy
#12
Timothy Craig Allen
Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are two of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years...
April 18, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28414410/preparing-family-physicians-to-care-for-underserved-populations-a-historical-perspective
#13
Denise V Rodgers, Andrea L Wendling, George W Saba, Megan Ruth Mahoney, Joedrecka S Brown Speights
Family physicians have been involved in the care of rural and urban underserved populations since the founding of the specialty. In the early 1970s family medicine training programs specifically focused on training residents to work with the underserved were established in both urban and rural settings. Key to the success of these programs has been a specific focus on improving access to care, understanding and eliminating health disparities, cultural competency and behavioral science training that recognizes the challenges often faced by patients and families living in poor rural and urban areas of the country...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28412072/do-slow-and-steady-residents-win-the-race-modeling-the-effects-of-peak-and-overall-resident-productivity-in-the-emergency-department
#14
Joshua W Joseph, Victor Novack, Matthew L Wong, Larry A Nathanson, Leon D Sanchez
BACKGROUND: Emergency medicine residents need to be staffed in a way that balances operational needs with their educational experience. Key to developing an optimal schedule is knowing a resident's expected productivity, a poorly understood metric. OBJECTIVE: We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift. METHODS: We conducted a retrospective, observational study of resident productivity at an urban, tertiary care center with a 3-year Accreditation Council for Graduate Medical Education-approved emergency medicine training program, with 55,000 visits annually...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28411120/effectiveness-and-safety-of-rivaroxaban-and-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-matched-nationwide-cohort-study
#15
Torben B Larsen, Flemming Skjøth, Jette N Kjældgaard, Gregory Y H Lip, Peter B Nielsen, Mette Søgaard
BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are collectively known as venous thromboembolism (VTE), which is a common vascular disease and a major cause of morbidity and mortality worldwide. We compare effectiveness and safety of rivaroxaban versus warfarin in a prospective cohort of routine care patients with incident unprovoked VTE. METHODS: In this propensity-matched cohort study, we linked nationwide Danish health registries to identify all patients with a first hospital diagnosis of unprovoked VTE who were new users of rivaroxaban or warfarin...
April 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28407806/development-and-validation-of-classifiers-and-variable-subsets-for-predicting-nursing-home-admission
#16
Mikko Nuutinen, Riikka-Leena Leskelä, Ella Suojalehto, Anniina Tirronen, Vesa Komssi
BACKGROUND: In previous years a substantial number of studies have identified statistically important predictors of nursing home admission (NHA). However, as far as we know, the analyses have been done at the population-level. No prior research has analysed the prediction accuracy of a NHA model for individuals. METHODS: This study is an analysis of 3056 longer-term home care customers in the city of Tampere, Finland. Data were collected from the records of social and health service usage and RAI-HC (Resident Assessment Instrument - Home Care) assessment system during January 2011 and September 2015...
April 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28397649/support-and-assessment-for-fall-emergency-referrals-safer-2-a-cluster-randomised-trial-and-systematic-review-of-clinical-effectiveness-and-cost-effectiveness-of-new-protocols-for-emergency-ambulance-paramedics-to-assess-older-people-following-a-fall-with-referral
#17
Helen A Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze, Mary Halter, Ioan Humphreys, Marina Koniotou, Phillipa Logan, Ronan Lyons, Suzanne Mason, Jon Nicholl, Julie Peconi, Ceri Phillips, Judith Phillips, Alison Porter, A Niroshan Siriwardena, Graham Smith, Alun Toghill, Mushtaq Wani, Alan Watkins, Richard Whitfield, Lynsey Wilson, Ian T Russell
BACKGROUND: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. OBJECTIVES: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28396693/prevalence-of-non-communicable-diseases-and-access-to-health-care-and-medications-among-yazidis-and-other-minority-groups-displaced-by-isis-into-the-kurdistan-region-of-iraq
#18
Valeria Cetorelli, Gilbert Burnham, Nazar Shabila
BACKGROUND: The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq. METHODS: The study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28396111/mental-health-services-claims-and-adult-onset-asthma-in-ontario-canada
#19
Teresa To, Kandace Ryckman, Jingqin Zhu, Devon Williams, Laura Y Feldman, Kristian Larsen, Andrea Gershon
BACKGROUND: Living with asthma is associated with a decrease in quality of life due to reductions in activities of daily living and increased psychological stress, both of which are associated with poor mental health outcomes. OBJECTIVE: The objective of this study was to quantify the burden of mental disorders on the adult asthma population and compare the risk of mental health services claims (MHSCs) in the 1 year before and 1 year after asthma diagnosis. METHODS: Ontario residents aged 25 to 65 years with incident physician-diagnosed asthma between April 1, 2005, and March 31, 2012, were included...
April 7, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28395059/hospitalization-event-notifications-and-reductions-in-readmissions-of-medicare-fee-for-service-beneficiaries-in-the-bronx-new-york
#20
Mark Aaron Unruh, Hye-Young Jung, Rainu Kaushal, Joshua R Vest
Objective: Follow-up with a primary care provider after hospital discharge has been associated with a reduced likelihood of readmission. However, primary care providers are frequently unaware of their patients' hospitalizations. Event notification may be an effective tool for reducing readmissions by notifying primary care providers when their patients have been admitted to and discharged from a hospital. Materials and Methods: We examined the effect of an event notification system on 30-day readmissions in the Bronx, New York...
April 1, 2017: Journal of the American Medical Informatics Association: JAMIA
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