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https://www.readbyqxmd.com/read/27920246/beyond-utilization-measuring-effective-coverage-of-obstetric-care-along-the-quality-cascade
#1
Elysia Larson, Daniel Vail, Godfrey M Mbaruku, Redempta Mbatia, Margaret E Kruk
OBJECTIVE: To determine the effective coverage of obstetric care in a rural Tanzanian region and to assess differences in effective coverage by wealth. DESIGN: Cross-sectional structured interviews. SETTING: Pwani Region, Tanzania. PARTICIPANTS: The study includes 24 rural, government-managed, primary healthcare clinics and their catchment populations. From January-April 2016, we conducted a household survey of a census of women with recent deliveries, health worker knowledge surveys and facility audits...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920083/nocturnal-antihypertensive-treatment-in-patients-with-type-1-diabetes-with-autonomic-neuropathy-and-non-dipping-a-randomised-placebo-controlled-double-blind-cross-over-trial
#2
Henrik Øder Hjortkjær, Tonny Jensen, Klaus F Kofoed, Ulrik M Mogensen, Per Ejlstrup Sigvardsen, Lars Køber, Karen Lisa Hilsted, Helle Corinth, Simone Theilade, Jannik Hilsted
OBJECTIVES: Cardiovascular autonomic neuropathy (CAN) and abnormal circadian blood pressure (BP) rhythm are independent cardiovascular risk factors in patients with diabetes and associations between CAN, non-dipping of nocturnal BP and coronary artery disease have been demonstrated. We aimed to test if bedtime dosing (BD) versus morning dosing (MD) of the ACE inhibitor enalapril would affect the 24-hour BP profile in patients with type 1 diabetes (T1D), CAN and non-dipping. SETTING: Secondary healthcare unit in Copenhagen, Denmark...
December 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27920082/doctors-perspectives-on-psa-testing-illuminate-established-differences-in-prostate-cancer-screening-rates-between-australia-and-the-uk-a-qualitative-study
#3
Kristen Pickles, Stacy M Carter, Lucie Rychetnik, Vikki A Entwistle
OBJECTIVES: To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different. DESIGN: A grounded theory study. SETTING: Primary care practices in Australia and the UK. PARTICIPANTS: 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations...
December 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27919385/usability-problems-do-not-heal-by-themselves-national-survey-on-physicians-experiences-with-ehrs-in-finland
#4
Johanna Kaipio, Tinja Lääveri, Hannele Hyppönen, Suvi Vainiomäki, Jarmo Reponen, Andre Kushniruk, Elizabeth Borycki, Jukka Vänskä
PURPOSE: Survey studies of health information systems use tend to focus on availability of functionalities, adoption and intensity of use. Usability surveys have not been systematically conducted by any healthcare professional groups on a national scale on a repeated basis. This paper presents results from two cross-sectional surveys of physicians' experiences with the usability of currently used EHR systems in Finland. The research questions were: To what extent has the overall situation improved between 2010 and 2014? What differences are there between healthcare sectors? METHODS: In the spring of 2014, a survey was conducted in Finland using a questionnaire that measures usability and respondents' user experiences with electronic health record (EHR) systems...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919103/primary-care-based-models-for-the-treatment-of-opioid-use-disorder-a-scoping-review
#5
P Todd Korthuis, Dennis McCarty, Melissa Weimer, Christina Bougatsos, Ian Blazina, Bernadette Zakher, Sara Grusing, Beth Devine, Roger Chou
Greater integration of medication-assisted treatment (MAT) for opioid use disorder (OUD) in U.S. primary care settings would expand access to treatment for this condition. Models for integrating MAT into primary care vary in structure. This article summarizes findings of a technical report for the Agency for Healthcare Research and Quality describing MAT models of care for OUD, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27917771/socioeconomic-and-modifiable-predictors-of-blood-pressure-control-for-hypertension-in-primary-care-attenders-in-the-western-cape-south-africa
#6
N Folb, M O Bachmann, E D Bateman, K Steyn, N S Levitt, V Timmerman, C Lombard, T A Gaziano, L R Fairall
BACKGROUND: Low socioeconomic status is associated with the risk of hypertension. There are few reports of the effect of socioeconomic and potentially modifiable factors on the control of hypertension in South Africa (SA). OBJECTIVES: To investigate associations between patients' socio-economic status and characteristics of primary healthcare facilities, and control and treatment of blood pressure in hypertensive patients. METHODS: We enrolled hypertensive patients attending 38 public sector primary care clinics in the Western Cape, SA, in 2011, and followed them up 14 months later as part of a randomised controlled trial...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917770/evaluating-point-of-care-testing-for-glycosylated-haemoglobin-in-public-sector-primary-care-facilities-in-the-western-cape-south-africa
#7
R Mash, A Ugoagwu, C Vos, M Rensburg, R Erasmus
BACKGROUND: Diabetes mellitus contributes significantly to the burden of disease in South Africa (SA). Monitoring of glycaemic control with glycosylated haemoglobin (HbA1c) is recommended, even though current laboratory-based testing does not support immediate clinical decision-making. OBJECTIVES: To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917402/academic-institution-pilot-study-shows-far-fewer-diagnoses-of-sinusitis-than-reported-nationally
#8
Sarah R Akkina, Sarah J Novis, Nahid R Keshavarzi, Melissa A Pynnonen
OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross-sectional pilot study of institutional census data and a population-based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally. MATERIALS AND METHODS: We determined the proportion of adults visits at our institution for AS and CS from January 1, 2005, to December 31, 2010...
October 2016: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/27916915/evaluation-of-a-tracking-system-for-patients-and-mixed-intravenous-medication-based-on-rfid-technology
#9
María Martínez Pérez, Guillermo Vázquez González, Carlos Dafonte
At present, one of the primary concerns of healthcare professionals is how to increase the safety and quality of the care that patients receive during their stay in hospital. This is particularly important in the administration of expensive and high-risk medicines with which it is fundamental to minimize the possibility of adverse events in the process of prescription-validation-preparation/dosage-dispensation-administration of intravenous mixes. This work is a detailed analysis of the evaluation, carried out by the health personnel involved in the Radiofrequency Identification (RFID) system developed in the Day Hospital and Pharmacy services of the Complejo Hospitalario Universitario A Coruña (CHUAC)...
November 30, 2016: Sensors
https://www.readbyqxmd.com/read/27916749/inequalities-in-receipt-of-mental-and-physical-healthcare-in-people-with-dementia-in-the-uk
#10
Claudia Cooper, Rebecca Lodwick, Kate Walters, Rosalind Raine, Jill Manthorpe, Steve Iliffe, Irene Petersen
BACKGROUND: UK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia. METHODS: we investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002-13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men...
December 4, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27916431/2016-scct-str-guidelines-for-coronary-artery-calcium-scoring-of-noncontrast-noncardiac-chest-ct-scans-a-report-of-the-society-of-cardiovascular-computed-tomography-and-society-of-thoracic-radiology
#11
Harvey S Hecht, Paul Cronin, Michael J Blaha, Matthew J Budoff, Ella A Kazerooni, Jagat Narula, David Yankelevitz, Suhny Abbara
The Society of Cardiovascular Computed Tomography (SCCT) and the Society of Thoracic Radiology (STR) have jointly produced this document. Experts in this subject have been selected from both organizations to examine subject-specific data and write this guideline in partnership. A formal literature review, weighing the strength of evidence has been performed. When available, information from studies on cost was considered. Computed tomography (CT) acquisition, CAC scoring methodologies and clinical outcomes are the primary basis for the recommendations in this guideline...
November 10, 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27916411/beyond-expectations-post-implementation-data-shows-rotavirus-vaccination-is-likely-cost-saving-in-australia
#12
J F Reyes, J G Wood, P Beutels, K Macartney, P McIntyre, R Menzies, N Mealing, A T Newall
BACKGROUND: Universal vaccination against rotavirus was included in the funded Australian National Immunisation Program in July 2007. Predictive cost-effectiveness models assessed the program before introduction. METHODS: We conducted a retrospective economic evaluation of the Australian rotavirus program using national level post-implementation data on vaccine uptake, before-after measures of program impact and published estimates of excess intussusception cases...
December 1, 2016: Vaccine
https://www.readbyqxmd.com/read/27916220/preventive-and-primary-care-for-lesbian-gay-and-bisexual-patients
#13
REVIEW
Sarah R Floyd, Deidre M Pierce, Stephen A Geraci
Among the minorities underserved by today׳s healthcare system, the lesbian, gay and bisexual (LGB) population may be the least studied, and the least understood by healthcare providers. High-quality evidence is often lacking regarding optimal preventive care measures, both in medical areas that (to date) fail to identify differences in need between LGB and heterosexual patients, and in those more prevalent in or more specific (or both) to sexual minorities. Issues of substance abuse, sexual health and sexually transmitted diseases, obesity and other eating disorders, cardiovascular prevention, cancer prevention and screening, depression and other psychological disorders, social isolation and personal and intimate partner violence are all as or more important to address in LGB patients as they are in the general American population...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27914719/-validation-of-the-knowledge-and-attitudes-of-health-professionals-in-the-living-will-declaration-process
#14
Eugenio Contreras-Fernández, Francisco Javier Barón-López, Camila Méndez-Martínez, José Carlos Canca-Sánchez, Isabel Cabezón Rodríguez, Francisco Rivas-Ruiz
OBJECTIVE: Evaluate the validity and reliability of the knowledge and attitudes of health professionals questionnaire on the Living Will Declaration (LWD) process. DESIGN: Cross-sectional study structured into 3 phases: (i)pilot questionnaire administered with paper to assess losses and adjustment problems; (ii)assessment of the validity and internal reliability, and (iii)assessment of the pre-filtering questionnaire stability (test-retest). LOCATION: Costa del Sol (Malaga) Health Area...
November 30, 2016: Atencion Primaria
https://www.readbyqxmd.com/read/27912783/exploring-levers-and-barriers-to-accessing-primary-care-for-marginalised-groups-and-identifying-their-priorities-for-primary-care-provision-a-participatory-learning-and-action-research-study
#15
Patrick O'Donnell, Edel Tierney, Austin O'Carroll, Diane Nurse, Anne MacFarlane
BACKGROUND: The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care...
December 3, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#16
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911004/a-comparison-of-the-neuropsychological-profiles-of-people-living-in-squalor-without-hoarding-to-those-living-in-squalor-associated-with-hoarding
#17
Sook Meng Lee, Matthew Lewis, Deborah Leighton, Ben Harris, Brian Long, Stephen Macfarlane
OBJECTIVE: Squalor affects 1 in 1000 older people and is regarded as a secondary condition to other primary disorders such as dementia, intellectual impairment and alcohol abuse. Squalor frequently is associated with hoarding behaviour. We compared the neuropsychological profile of people living in squalor associated with hoarding to those presenting with squalor only. METHODS: This study is a retrospective case series of hospital inpatient and community healthcare services of 69 people living in squalor (49 from aged care, 16 from aged psychiatry, 3 from acute medical and 1 from a memory clinic)...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27909944/using-an-analysis-of-behavior-change-to-inform-effective-digital-intervention-design-how-did-the-primit-website-change-hand-hygiene-behavior-across-8993-users
#18
B Ainsworth, M Steele, B Stuart, J Joseph, S Miller, L Morrison, P Little, L Yardley
BACKGROUND: In designing digital interventions for healthcare, it is important to understand not just whether interventions work but also how and for whom-including whether individual intervention components have different effects, whether a certain usage threshold is required to change behavior in each intervention and whether usage differs across population subgroups. PURPOSE: We investigated these questions using data from a large trial of the digital PRimary care trial of a website based Infection control intervention to Modify Influenza-like illness and respiratory tract infection Transmission) (PRIMIT) intervention, which aimed to reduce respiratory tract infections (RTIs) by increasing hand hygiene behavior...
December 1, 2016: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/27909937/exploring-the-migration-profiles-of-primary-healthcare-users-in-south-africa
#19
Jo Vearey, Thea de Gruchy, Mphatso Kamndaya, Helen L Walls, Candice M Chetty-Makkan, Johanna Hanefeld
South Africa's public healthcare system responses seldom engage with migration. Our exploratory study investigates migration profiles and experiences of primary healthcare (PHC) users. A cross-sectional survey involving non-probability sampling was conducted with 229 PHC users at six purposively selected PHC clinics in three districts of SA. The survey captured socio-demographic information, migration histories, and PHC experiences. Chi square and Fischer's exact tests were used to compare categorical variables, whilst Mann-Whitney U tests compared continuous variables between groups...
December 1, 2016: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/27909642/seasonal-variations-and-trends-in-hospitalization-for-peptic-ulcer-disease-in-the-united-states-a-12-year-analysis-of-the-nationwide-inpatient-sample
#20
Ritesh Kanotra, Moiz Ahmed, Nileshkumar Patel, Badal Thakkar, Shantanu Solanki, Sarah Tareen, Matthew J Fasullo, Mayurathan Kesavan, Nikhil Nalluri, Ahsan Khan, Dhaval Pau, Liliane Deeb, Jeffrey Abergel, Ananya Das
BACKGROUND: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011. METHODS: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531...
October 30, 2016: Curēus
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