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https://www.readbyqxmd.com/read/29668145/-lost-in-transition-crossed-looks-on-the-18-25-years-old
#1
Sarah Depallens, Yusuke Leo Takeuchi, Katherine Roberts
Social determinants have an impact on patients' access to care and on their health at any age. Young adults are a population at risk of being affected in their health because of a lack of social protection or unavailability of healthcare system adapted to their specific needs. Primary healthcare providers need to identify that window of social vulnerability in order to avoid a discontinuation in healthcare and to prevent biopsychosocial co-morbidity leading to ongoing consequences on their health.
April 18, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29667378/alarming-results-of-nosocomial-infections-in-a-multicenter-program-of-surveillance-in-polish-intensive-care-units
#2
Michał Wałaszek, Anna Różańska, Małgorzata Bulanda, Jadwiga Wojkowska-Mach, Polish Society of Hospital Infections Team
INTRODUCTION: Nosocomial bloodstream infections (BSI) among patients in intensive care units (ICU) are the most common form of nosocomial infections and they are serious complications of the treatment process. The etiological factors of these infections and the proper antibiotic therapy can influence the effects of patient treatment. The aim of the study was to analyze the epidemiology, microbiology and antibiotic therapy of nosocomial BSI in Polish ICU patients. MATERIALS AND METHODS: The retrospective study covered patients hospitalized in seven ICUs for adults with a general profile, located in southern Poland...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29667158/obesity-prevention-and-management-strategies-in-canada-shifting-paradigms-and-putting-people-first
#3
REVIEW
Arya M Sharma, Ximena Ramos Salas
PURPOSE OF REVIEW: The purpose of this study was to review public and private sector obesity policies in Canada and to make recommendations for future evidence-based obesity prevention and management strategies. RECENT FINDINGS: Synthesis of obesity prevention and management policies and research studies are presented in three primary themes: (1) Increased awareness about the impact of weight bias and obesity stigma in Canada; (2) Inadequate government obesity prevention and management policies and strategies; and (3) Lack of comprehensive private sector obesity prevention and management policies...
April 17, 2018: Current Obesity Reports
https://www.readbyqxmd.com/read/29666131/doctors-on-the-move-a-european-case-study-on-the-key-characteristics-of-national-recertification-systems
#4
Carolin Sehlbach, Marjan J Govaerts, Sharon Mitchell, Gernot G U Rohde, Frank W J M Smeenk, Erik W Driessen
OBJECTIVES: With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors' professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. DESIGN AND SETTING: We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study)...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29665855/dutch-citizens-of-turkish-origin-who-utilize-healthcare-services-in-turkey-a-qualitative-study-on-motives-and-contextual-factors
#5
Aydın Şekercan, Anke J Woudstra, Ron J G Peters, Majda Lamkaddem, Seval Akgün, Marie-Louise Essink-Bot
BACKGROUND: Dutch residents of Turkish origin frequently utilize healthcare in Turkey. METHODS: To investigate their motives for doing so, we conducted a qualitative study among these healthcare users using semi-structured interviews. We complemented this with informal conversations with Turkish healthcare providers and observations at the registration offices and waiting rooms of outpatient clinics in several Turkish hospitals. RESULTS: Respondents believed their perceived needs for referral to specialist care and diagnostic assessments to quantify their health were not being met in the Netherlands...
April 17, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29665833/intervention-using-vitamin-d-for-elevated-urinary-albumin-in-type-2-diabetes-mellitus-ideal-2-study-study-protocol-for-a-randomised-controlled-trial
#6
Shahrad Taheri, Muhammad Asim, Hassan Al Malki, Omar Fituri, Manikkam Suthanthiran, Phyllis August
BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. T2DM is associated with serious macro- and microvascular complications. In particular, diabetic kidney disease (DKD), which begins with excessive urinary albumin excretion, has a significant impact on affected individuals and is costly to healthcare services. Inhibition of the renin-angiotensin-aldosterone system (RAAS) with angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) significantly reduces albuminuria in diabetes, but this effect is not observed in all those treated...
April 17, 2018: Trials
https://www.readbyqxmd.com/read/29665702/current-weight-management-approaches-used-by-primary-care-providers-in-six-multidisciplinary-healthcare-settings-in-ontario
#7
Stephanie Aboueid, Monika Jasinska, Ivy Bourgeault, Isabelle Giroux
Background Obesity management in primary care has been suboptimal due to lack of access to allied health professionals, time, and resources. Purpose To understand the weight management approaches used by primary care providers working in team-based settings and how they assess the most suitable approach for a patient. Methods A total of 20 primary care providers (13 nurse practitioners and 7 family physicians) working in 6 multidisciplinary clinics in Ontario were interviewed. All interviews were recorded, transcribed verbatim, and coded using NVivo qualitative software...
January 1, 2018: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
https://www.readbyqxmd.com/read/29665231/estrogen-returns-to-the-stage-in-melanoma
#8
Jennifer L McQuade, Michael A Davies
It has long been recognized that female sex is associated with a lower risk of and improved survival in melanoma (Joosse et al., 2012). However, the mechanism underlying this disparity in outcomes is not understood. One potential explanation is behavioral- i.e. differences by sex in UV exposure, screening and detection, and healthcare utilization. Observed differences between men and women in prognostic factors in primary melanomas would support this. For example, men are more likely to have thicker, ulcerated tumors, which could reflect diagnostic delays...
April 17, 2018: Pigment Cell & Melanoma Research
https://www.readbyqxmd.com/read/29665097/real-world-use-of-elbasvir-grazoprevir-in-patients-with-chronic-hepatitis-c-retrospective-analyses-from-the-trio-network
#9
S L Flamm, B Bacon, M P Curry, S Milligan, C U Nwankwo, N Tsai, Z Younossi, N Afdhal
BACKGROUND: Elbasvir-grazoprevir is indicated for chronic hepatitis C virus (HCV) genotypes 1 and 4. AIMS: To evaluate the utilization and outcomes of chronic HCV patients treated with elbasvir-grazoprevir in the United States. METHODS: We conducted a retrospective cohort study of adults treated with elbasvir-grazoprevir with or without ribavirin for chronic HCV genotypes 1 or 4 infection. Data were collected from healthcare providers and specialty pharmacies through Innervation Platform, a proprietary, cloud-based disease management program from Trio Health...
April 17, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29664893/occupational-exposure-during-emergency-department-thoracotomy-a-prospective-multi-institution-study
#10
Andrew Nunn, Priya Prakash, Kenji Inaba, Alvarez Escalante, Zoë Maher, Seiji Yamaguchi, Dennis Y Kim, James Maciel, William C Chiu, Byron Drumheller, Joshua P Hazelton, Kaushik Mukherjee, Xian Luo-Owen, Rachel M Nygaard, Ashley P Marek, Bryan C Morse, Caitlin A Fitzgerald, Patrick L Bosarge, Randeep S Jawa, Susan E Rowell, Louis J Magnotti, Adrian W Ong, Tejal S Brahmbhatt, Michael D Grossman, Mark J Seamon
BACKGROUND: Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While HIV/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. METHODS: A prospective, observational study at 16 US trauma centers was performed (2015-2016)...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664674/associations-between-neighborhood-walkability-and-incident-and-ongoing-asthma-in-children
#11
Elinor Simons, Sharon D Dell, Rahim Moineddin, Teresa To
RATIONALE: Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes. OBJECTIVES: We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma. METHODS: This population-based cohort study used prospectively-collected administrative healthcare data for the province of Ontario housed at the Institute for Clinical Evaluative Sciences...
April 17, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29664672/primary-care-physicians-can-comprehensively-manage-sleep-apnea-patients-a-non-inferiority-randomized-controlled-trial
#12
M Ángeles Sánchez-Quiroga, Jaime Corral, Francisco J Gómez-de-Terreros, Carmen Carmona-Bernal, M Isabel Asensio-Cruz, Marta Cabello, M Ángeles Martínez-Martínez, Carlos J Egea, Estrella Ordax, Ferran Barbe, Javier Barca, Juan F Masa
RATIONALE: General practitioners play a passive role in obstructive sleep apnea (OSA) management. Simplification of the diagnosis and use of a semi-automatic algorithm for treatment can facilitate the integration of general practitioners, which has cost advantages. OBJECTIVE: To determine differences in effectiveness between primary healthcare area (PHA) and in-hospital specialized management protocols during six months of follow-up. METHOD: A multicenter, non-inferiority, randomized, controlled trial with two open parallel arms and a cost-effectiveness analysis was performed in six tertiary hospitals in Spain...
April 17, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29664026/prenatal-screening-for-genetic-disorders-suggested-guidelines-for-the-indian-scenario
#13
REVIEW
Shubha R Phadke, Ratna D Puri, Prajnya Ranganath
Prenatal testing is the best strategy for reducing the burden of genetic disorders and congenital disabilities that cause significant postnatal functional impairment. Universal prenatal screening is advisable for common genetic disorders and congenital anomalies such as Down syndrome, beta-thalassaemia and neural tube defects. Several prenatal-screening tests are now available for Down syndrome, but knowledge about the appropriate timing of the test and the need for pre- and post-test counselling may not be updated among the primary care physicians...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29661670/-community-acquired-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease-treated-with-inhaled-corticosteroids-or-other-bronchodilators-study-pneumocort
#14
Rosa Morros, Cristina Vedia, Maria Giner-Soriano, Aina Casellas, Ester Amado, Jose Miguel Baena
OBJECTIVES: To analyse the risk of pneumonia and/or exacerbations in patients with chronic obstructive pulmonary disease (COPD) who receive treatment with inhaled corticosteroids (CI), in comparison with those who are not treated with inhaled corticosteroids (NCI). To estimate the risk of pneumonia according to CI dose. DESIGN: Population-based cohort study. SETTING: Primary Healthcare. Institut Català de la Salut. PARTICIPANTS: Patients ≥45 years-old diagnosed with COPD between 2007 and 2009 in the Information System for Research in Primary Care (SIDIAP)...
April 13, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29661291/hemodialysis-patients-have-worse-outcomes-after-infrageniculate-revascularization-procedures
#15
Caitlin W Hicks, Joseph K Canner, Kevin Kirkland, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: Hemodialysis (HD) has been shown to be an independent predictor of poor outcomes after femoropopliteal revascularization procedures in patients with chronic limb-threatening ischemia. However, HD patients tend to have isolated infrageniculate disease, an anatomic risk factor for inferior patency. We aimed to compare outcomes for HD versus non-HD patients after infrageniculate open lower extremity bypass (LEB) and endovascular peripheral vascular interventions (PVIs). METHODS: Data from the Society for Vascular Surgery Vascular Quality Initiative database (2008-2014) were analyzed...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29661218/endometrial-cancer-survivors-follow-up-care-ensure-less-is-more-evaluating-patient-satisfaction-and-cost-effectiveness-of-a-reduced-follow-up-schedule-study-protocol-of-a-randomized-controlled-trial
#16
Nicole P M Ezendam, Belle H de Rooij, Roy F P M Kruitwagen, Carien L Creutzberg, Ingrid van Loon, Dorry Boll, M Caroline Vos, Lonneke V van de Poll-Franse
BACKGROUND: It has often been hypothesized that the frequency of follow-up visits for patients with early-stage endometrial cancer could be decreased. However, studies evaluating effects of a reduced follow-up schedule among this patient group are lacking. The aim of this study is to assess patient satisfaction and cost-effectiveness of a less frequent follow-up schedule compared to the schedule according to the Dutch guideline. METHODS: In this multicenter randomized controlled trial, patients diagnosed in the Netherlands with stage 1A and 1B low-risk endometrial cancer, for whom adjuvant radiotherapy is not indicated (n = 282), are randomized...
April 16, 2018: Trials
https://www.readbyqxmd.com/read/29661170/-people-look-and-ask-lots-of-questions-caregivers-perceptions-of-healthcare-provision-and-support-for-children-born-with-cleft-lip-and-palate
#17
Phumzile Hlongwa, Laetitia C Rispel
BACKGROUND: Clefting of the lip and/or palate (CL/P) is amongst the five most common birth defects reported in South Africa. The emotional impact on parents at the birth of their new-born with CL/P could affect parent-child relationships. In light of insufficient scholarly attention parental experiences and perceptions, this study reports on caregivers' perceptions of health service provision and support for children born with cleft lip and palate in South Africa. METHODS: The study setting consisted of 11 academic hospital centres situated in six of South Africa's nine provinces...
April 16, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29660573/midwifery-in-iceland-from-vocational-training-to-university-education
#18
Olof A Olafsdottir, Hildur Kristjansdottir, Berglind Halfdansdottir, Helga Gottfredsdottir
Midwifery education is a foundation for health professionals' competence in providing quality healthcare for the benefit of women, their families and society. This paper describes midwifery and the development of midwifery education in Iceland. It examines policy and extensive reforms, from hospital-based vocational training in midwifery to an academic university education, and the impact on the scope of midwifery practice in Iceland. The university-based programme, with its emphasis on autonomy of the midwife, seems to have affected the context of home birth and strengthened midwives' role in primary healthcare...
April 3, 2018: Midwifery
https://www.readbyqxmd.com/read/29660525/gastric-peroral-endoscopic-pyloromyotomy-reduces-symptoms-increases-quality-of-life-and-reduces-healthcare-usage-for-patients-with-gastroparesis
#19
Parit Mekaroonkamol, Sunil Dacha, Lei Wang, Xiaoyu Li, Yueping Jiang, Lianyong Li, Tian Li, Nikrad Shahnavaz, Sonali Sakaria, Francis E LeVert, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
BACKGROUND AND AIMS: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is becoming a promising treatment option for patients with refractory gastroparesis. We aimed to systematically assess the efficacy of GPOEM and its effects on healthcare usage. METHODS: We performed a retrospective study on 30 patients with refractory gastroparesis who underwent GPOEM from June 2015 through July 2017 at a tertiary center. We compared outcomes with those of 7 patients with refractory gastroparesis who did not undergo the procedure (controls)...
April 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29660212/aiming-for-elimination-outcomes-of-a-consultation-pathway-supporting-regional-general-practitioners-to-prescribe-direct-acting-antiviral-therapy-for-hepatitis-c
#20
A J Wade, A McCormack, C Roder, K McDonald, M Davies, N Scott, M Wardrop, E Athan, M E Hellard
To increase access to treatment, the Australian government enabled general practitioners (GPs) to prescribe direct-acting antivirals (DAA) to treat hepatitis C virus (HCV) - in consultation with a specialist if inexperienced in HCV management. This study describes the establishment and outcomes of a remote consultation pathway supporting GPs to treat HCV. Key stakeholders from primary and tertiary healthcare services in the Barwon South Western region developed and implemented an HCV remote consultation pathway...
April 16, 2018: Journal of Viral Hepatitis
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