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https://www.readbyqxmd.com/read/27909550/information-seeking-and-anxiety-among-colonoscopy-na%C3%A3-ve-adults-direct-to-colonoscopy-vs-traditional-consult-first-pathways
#1
Jocelyn A Silvester, Harmandeep Kalkat, Lesley A Graff, John R Walker, Harminder Singh, Donald R Duerksen
AIM: To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-naïve patients. METHODS: Colonoscopy-naïve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation. Survey items included clinical pathway (direct or consult), procedure indication (cancer screening or symptom investigation), telephone and written contact from the physician endoscopist office, information sources, and pre-procedure anxiety...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27909073/accuracy-of-outpatient-service-data-for-activity-based-funding-in-new-south-wales-australia
#2
Esther N Munyisia, David Reid, Ping Yu
BACKGROUND: Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. OBJECTIVE: This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. METHODS: An audit was carried out on healthcare workers' (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system...
December 1, 2016: HIM Journal
https://www.readbyqxmd.com/read/27906960/perceptions-and-attitudes-towards-medication-error-reporting-in-primary-care-clinics-a-qualitative-study-in-malaysia
#3
A Samsiah, Noordin Othman, Shazia Jamshed, Mohamed Azmi Hassali
OBJECTIVE: To explore and understand participants' perceptions and attitudes towards the reporting of medication errors (MEs). METHODS: A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers...
2016: PloS One
https://www.readbyqxmd.com/read/27906645/age-differences-in-visits-to-office-based-physicians-by-adults-with-hypertension-united-states-2013
#4
Jill J Ashman, Pinyao Rui, Susan M Schappert
Data from the National Ambulatory Medical Care Survey •The percentage of all adult visits to office-based physicians made by adults with hypertension increased with age, from 9% for those aged 18-44 to 58% for those aged 75 and over. •Hypertensive medications were provided, prescribed, or continued at 62% of visits made by adults with hypertension. •Eighty-two percent of visits by adults with hypertension were made by those with multiple chronic conditions, and the number of chronic conditions increased with age...
November 2016: NCHS Data Brief
https://www.readbyqxmd.com/read/27905018/minimal-excision-and-primary-suture-is-a-cost-efficient-definitive-treatment-for-pilonidal-disease-with-low-morbidity-a-population-based-interventional-and-a-cross-sectional-cohort-study
#5
Kaveh Khodakaram, Joachim Stark, Ida Höglund, Roland E Andersson
BACKGROUND: Conventional treatment of pilonidal disease with wide excision is associated with high morbidity. We describe the short- and long-term results and the impact on the health care system of a simple operation performed in the office under local anaesthesia, consisting of minimal excision of pilonidal sinuses with primary suture-the modified Lord-Millar operation (mLM). METHODS: All patients operated with mLM from February 2008 till November 2012 were prospectively followed for recurrence by telephone interviews and examination of symptomatic patients till July 2015...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27887032/provider-perception-of-pharmacy-services-in-the-patient-centered-medical-home
#6
Nicole P Albanese, Alyssa M Pignato, Scott V Monte
BACKGROUND: Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. OBJECTIVE: To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. METHODS: A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group...
November 24, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27886697/nonsurgical-management-of-osteoarthritis-knee-pain-in-the-older-adult
#7
REVIEW
Nora Taylor
Symptomatic knee osteoarthritis is a common complaint of many elderly patients in primary care offices. For those unable or unwilling to undergo knee replacement, the primary practitioners' understanding of the strengths and weaknesses of the available treatment modalities for pain relief is critical to successful in-office counseling and expectation management. Treatment requires a multimodal approach of nonpharmacologic and pharmacologic therapies to achieve a maximal clinical benefit. The focus of this review is on the nonsurgical options for treatment of knee osteoarthritis in patients aged 65 and older...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27884924/low-acuity-presentations-to-the-emergency-department-in-canada-exploring-the-alternative-attempts-to-avoid-presentation
#8
Lynette D Krebs, Scott W Kirkland, Rajiv Chetram, Taylor Nikel, Britt Voaklander, Alan Davidson, Bryn Holroyd, Cristina Villa-Roel, Katelynn Crick, Stephanie Couperthwaite, Chris Alexiu, Garnet Cummings, Brian H Rowe
OBJECTIVE: ED visits have been rising year on year worldwide. It has been suggested that some of these visits could be avoided if low-acuity patients had better primary care access. This study explored patients' efforts to avoid ED presentation and alternative care sought prior to presentation. METHODS: Consecutive adult patients presenting to three urban EDs in Edmonton, Canada, completed a questionnaire collecting demographics, actions attempted to avoid presentation and reasons for presentation...
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27882866/the-performance-of-community-health-workers-in-the-management-of-multiple-childhood-infectious-diseases-in-lira-northern-uganda-a-mixed-methods-cross-sectional-study
#9
Phillip Wanduru, Moses Tetui, Doreen Tuhebwe, Michael Ediau, Monica Okuga, Christine Nalwadda, Elizabeth Ekirapa-Kiracho, Peter Waiswa, Elizeus Rutebemberwa
BACKGROUND: Community health workers (CHWs) have the potential to reduce child mortality by improving access to care, especially in remote areas. Uganda has one of the highest child mortality rates globally. Moreover, rural areas bear the highest proportion of this burden. The optimal performance of CHWs is critical. In this study, we assess the performance of CHWs in managing malaria, pneumonia, and diarrhea in the rural district of Lira, in northern Uganda. DESIGNS: A cross-sectional mixed methods study was undertaken to investigate the performance of 393 eligible CHWs in the Lira district of Uganda...
2016: Global Health Action
https://www.readbyqxmd.com/read/27882006/framingham-risk-score-in-impaired-glucose-tolerant-population-a-sub-analysis-of-diabetes-prevention-and-awareness-program-of-pakistan
#10
Asher Fawwad, Hassan Moin, Iftikhar Ahmed Siddiqui, Muhammad Zafar Iqbal Hydrie, Abdul Basit
OBJECTIVE: To assess the 10-year risk of coronary artery disease (CAD) in subjects with impaired glucose tolerance (IGT) using Framingham risk score. METHODS: Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27878397/-primary-health-care-in-austria-tu-felix-austria-nube-concept-for-networking-in-the-primary-care-of-upper-austria
#11
Johannes Kriegel, Erwin Rebhandl, Wolfgang Hockl, Anna-Maria Stöbich
The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas...
November 22, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27875118/women-s-health-is-personal-more-technologies-by-and-for-women-are-moving-into-the-mainstream-thanks-in-part-to-personalized-medicine
#12
Jennifer Berglund
One fall day in Boston, Ridhi Tariyal sat on an examination table in her primary care doctor's office. Her doctor sat across from her, hurriedly transcribing notes as Tariyal responded to the doctor's questions. It was the end of Tariyal's physical, and the waiting room was full. "Do you have any questions?" the doctor asked, not turning away from the computer screen.
November 2016: IEEE Pulse
https://www.readbyqxmd.com/read/27859257/does-spatial-access-to-primary-care-affect-emergency-department-utilization-for-nonemergent-conditions
#13
Jamie Fishman, Sara McLafferty, William Galanter
OBJECTIVE: To examine the contributions of individual- and neighborhood-level spatial access to care to the utilization of emergency departments (EDs) for preventable conditions through implementation of novel local spatial access measures. DATA SOURCES/STUDY SETTING: Emergency department admissions data are from four HealthLNK member hospitals in Chicago from 2007 to 2011. Primary care physician office and clinic locations were obtained from the American Medical Association and the City of Chicago...
November 17, 2016: Health Services Research
https://www.readbyqxmd.com/read/27852291/shifting-human-resources-for-health-in-the-context-of-art-provision-qualitative-and-quantitative-findings-from-the-lablite-baseline-study
#14
Misheck J Nkhata, Margaret Muzambi, Deborah Ford, Adrienne K Chan, George Abongomera, Harriet Namata, Ivan Mambule, Annabelle South, Paul Revill, Caroline Grundy, Travor Mabugu, Levison Chiwaula, James Hakim, Cissy Kityo, Andrew Reid, Elly Katabira, Sumeet Sodhi, Charles F Gilks, Diana M Gibb, Janet Seeley, Fabian Cataldo
BACKGROUND: Lablite is an implementation project supporting and studying decentralized antiretroviral therapy (ART) rollout to rural communities in Malawi, Uganda and Zimbabwe. Task shifting is one of the strategies to deal with shortage of health care workers (HCWs) in ART provision. Evaluating Human Resources for Health (HRH) optimization is essential for ensuring access to ART. The Lablite project started with a baseline survey whose aim was to describe and compare national and intercountry delivery of ART services including training, use of laboratories and clinical care...
November 16, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27849513/venous-thoracic-outlet-syndrome-the-role-of-early-rib-resection
#15
Vienna G Katana, Jeffrey S Weiss
The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27844476/coprescribing-naloxone-for-patients-on-chronic-opioid-therapy-les-sons-learned-from-a-patient-safety-initiative-in-primary-care-training-sites
#16
William Delaney, Jessica Huff, Sandra Mini, Aiswarya Thomas, Ralph Tremaglio
OBJECTIVE: To describe the development and implementation of a resident-led effort to increase coprescription of naloxone in a primary care setting. DESIGN: An exploratory, prospective pilot project to increase coprescription rates of naloxone. SETTING: Four primary care offices in western Connecticut serving as medical home training sites for primary care residents. PATIENTS, PARTICIPANTS: All patients on chronic opioid therapy...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27842581/impact-of-occupational-exposures-on-exacerbation-of-asthma-a-population-based-asthma-cohort-study
#17
Jeong-Lim Kim, Paul K Henneberger, Susanna Lohman, Anna-Carin Olin, Anna Dahlman-Höglund, Eva Andersson, Kjell Torén, Mathias Holm
BACKGROUND: Asthma is a prevalent chronic disease and occupation contributes to approximately 15 % of cases among adults. However, there are still few studies on risk factors for work-exacerbated asthma. The current study investigated the association between asthma exacerbations and occupational exposures. METHODS: The study comprised all currently working adults (n = 1356) who reported ever asthma in prior population-based cohorts. All subjects completed a questionnaire about exposures, occupations and exacerbations of asthma...
November 15, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27826707/diagnostic-yield-of-outpatient-pediatric-echocardiograms-impact-of-indications-and-specialty
#18
Sean M Lang, Elijah Bolin, Sarah Hardy, Xinyu Tang, R Thomas Collins
Multiple reports have shown that echocardiograms are neither cost-effective nor of high diagnostic yield for a number of indications. This study sought to evaluate the impact of indications and provider type on the diagnostic yield of first-time outpatient pediatric echocardiograms. All initial echocardiograms interpreted at our institution from February 2009 to December 2014 were reviewed retrospectively. Positive findings were defined as any abnormality of structure or function. Ordering physicians were grouped as Primary Care, Subspecialist, or Cardiologist...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27823587/overview-of-aortic-aneurysm-management-in-the-endovascular-era
#19
REVIEW
Aurelia Calero, Karl A Illig
Management of aortic aneurysm disease has changed in the endovascular era, with the majority of patients opting for stent-graft repair of abdominal and thoracic aneurysms. An understanding of this vascular condition is important for primary care, emergency medicine, medicine specialists, and vascular surgeons alike. Awareness of the patient risk factors for aneurysmal degeneration, sac rupture, and medical management allows physicians to screen appropriate patient populations, which decreases aneurysm-related mortality due to rupture...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27807591/value-and-clinical-impact-of-an-infectious-disease-supervised-outpatient-parenteral-antibiotic-therapy-program
#20
Russell M Petrak, Nathan C Skorodin, Robert M Fliegelman, David W Hines, Vishnu V Chundi, Brian P Harting
Background.  Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting. Methods.  Over a period of 32 months, 6120 patients were treated using 19 outpatient ID offices in 6 states. Analysis included patient demographics, indications of OPAT, diagnoses, therapeutic agent, duration of therapy, and site of therapy initiation. Outcomes were stratified by therapeutic success, clinical relapse, therapeutic complications, and hospitalizations after initiating therapy...
October 2016: Open Forum Infectious Diseases
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