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https://www.readbyqxmd.com/read/28427915/-multimorbidity-in-general-practice-and-the-ariadne-principles-a-person-centred-approach
#1
Alexandra Prados-Torres, Isabel Del Cura-González, Juan Daniel Prados-Torres, Francisca Leiva-Fernández, Juan Antonio López-Rodríguez, Amaia Calderón-Larrañaga, Christiane Muth
Multimorbidity, defined as the coexistence of two or more chronic conditions in one same individual, has negative consequences for people suffering from it and it poses a real challenge for health systems. In primary care, where most of these patients are attended, the clinical management of multimorbidity can be a complex task due, among others, to the high volume of clinical information that needs to be handled, the scarce scientific evidence available to approach multimorbidity, and the need for coordination among multiple health providers to guarantee continuity of care...
April 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28427405/ceiling-effect-in-emr-system-assimilation-a-multiple-case-study-in-primary-care-family-practices
#2
Marie-Claude Trudel, Josianne Marsan, Guy Paré, Louis Raymond, Ana Ortiz de Guinea, Éric Maillet, Thomas Micheneau
BACKGROUND: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs...
April 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28426125/cerclage-use-a-review-of-3-national-guidelines
#3
Jeffrey D Sperling, Joshua D Dahlke, Juan M Gonzalez
Importance: Preterm birth is a major contributor to perinatal morbidity and mortality. The most common intervention performed to improve perinatal outcomes for a woman experiencing cervical dilation in the second trimester without signs or symptoms of preterm labor is the cerclage. Objective: We sought to review and compare available national guidelines on cerclage use. Evidence Acquisition: We performed a descriptive review of 3 national guidelines on cerclage: The American Congress of Obstetricians and Gynecologists Practice Bulletin on "Cerclage for the Management of Cervical Insufficiency," Green-top Guideline from the Royal College of Obstetricians and Gynaecologists entitled "Cervical Cerclage," and the Society of Obstetricians and Gynaecologists of Canada Clinical Practice Bulletin entitled "Cervical Insufficiency and Cervical Cerclage...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28425580/the-patient-safety-climate-in-healthcare-organizations-pscho-survey-short-form-development
#4
Justin K Benzer, Mark Meterko, Sara J Singer
RATIONALE, AIMS, AND OBJECTIVES: Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate in Healthcare Organizations survey, a well-validated 38-item measure of safety climate. METHODS: The Patient Safety Climate in Healthcare Organizations was administered to all senior managers, all physicians, and a 10% random sample of all other hospital personnel in 69 private sector hospitals and 30 Veterans Health Administration hospitals...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28424869/review-on-diagnosis-and-management-of-urolithiasis-in-pregnancy-an-esut-practical-guide-for-urologists
#5
REVIEW
Bhaskar K Somani, Athanasios Dellis, Evangellos Liatsikos, Andreas Skolarikos
PURPOSE: Management of urolithiasis in pregnancy can be challenging for most urologists with diagnostic and treatment dilemma to ensure the best outcome for both mother and fetus. We wanted to review the literature for urolithiasis in pregnancy with a practical management guide for urologists. METHODS: A non-systematic review of literature was carried out for all English language literature using Medline. To ensure a more comprehensive search, the review of diagnosis and management of pregnant patients with urolithiasis was carried out separately, by two authors independently...
April 19, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#6
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28423227/a-national-survey-of-screening-and-management-of-hypogammaglobulinemia-in-canadian-transplantation-centers
#7
Samuel Bourassa-Blanchette, Greg Knoll, Jason Tay, Christopher Bredeson, Donald W Cameron, Juthaporn Cowan
BACKGROUND: Infection remains one of the most common transplant-related causes of death in patients undergoing transplantation. Secondary hypogammaglobulinemia (HGG) as a component of immune suppression and deficiency is associated with both solid organ (SOT) and hematopoietic cell transplantation (HCT). Available data and clinical experience for the supplementation of immunoglobulin (Ig) in these patients is conflicting, and clinical equipoise accounts for non-uniform practice in the use of Ig treatment...
April 18, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#8
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28418205/it-s-not-just-what-you-know-junior-trainees-approach-to-follow-up-and-documentation
#9
Dani C Cadieux, Mark Goldszmidt
CONTEXT: In teaching hospitals, junior trainees (first-year residents and third-year medical students) are responsible for patient follow-up and documentation under the supervision of senior team members. In order to support trainees in their role, supervisors need to understand how trainees approach these tasks and how they can be coached to develop best practices. OBJECTIVES: The purpose of our study was to explore the range of practices used by junior trainees in clinical settings...
April 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28417838/transferring-aviation-practices-into-clinical-medicine-for-the-promotion-of-high-reliability
#10
Nicole Powell-Dunford, Mark K McPherson, Joseph S Pina, Steven J Gaydos
BACKGROUND: Aviation is a classic example of a high reliability organization (HRO)-an organization in which catastrophic events are expected to occur without control measures. As health care systems transition toward high reliability, aviation practices are increasingly transferred for clinical implementation. METHODS: A PubMed search using the terms aviation, crew resource management, and patient safety was undertaken. Manuscripts authored by physician pilots and accident investigation regulations were analyzed...
May 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28417529/cardiovascular-risk-management-in-rheumatoid-arthritis-a-large-gap-to-close
#11
Karim Ladak, Jomana Hashim, Matthew Clifford-Rashotte, Vikas Tandon, Mark Matsos, Ameen Patel
OBJECTIVE: Rheumatoid arthritis (RA) portends significant cardiovascular morbidity and mortality. We therefore determined how often rheumatologists screened for and managed cardiovascular risk factors in RA patients, and the barriers to doing so. METHODS: We examined 300 patient charts from 10 university-affiliated rheumatology practices, to ascertain if they had been screened, treated and/or referred over a 3-year period. We subsequently distributed a national survey to Canadian rheumatologists to elucidate challenges in performing optimal cardiovascular risk modification...
April 18, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28417330/management-of-nasal-fractures-in-sports
#12
Yashika Patel, Peter Goljan, Todd P Pierce, Anthony Scillia, Kimona Issa, Vincent K McInerney, Anthony Festa
Nasal fractures represent approximately 60% of all maxillofacial injuries that occur in athletic activities; however, there are no current guidelines regarding immediate sideline management of these injuries. Therefore, the purpose of this article was to (1) summarize the anatomy, etiology, and incidence of nasal fractures, and (2) evaluate the current body of literature regarding immediate on-field and subsequent outpatient management. It is imperative to establish that the athlete's airway is not compromised and there are no other severe concomitant injuries, such as a concussion, ocular injury, or leakage of cerebrospinal fluid...
April 17, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28416995/sufficient-explanation-of-management-affects-patient-satisfaction-and-the-practice-of-post-treatment-management-in-spinal-pain-a-multicenter-study-of-1007-patients
#13
Jae Yun Kim, Jae Hang Shim, Sung Jun Hong, Jong Yeun Yang, Hey Ran Choi, Yun Hee Lim, Ho Sik Moon, Jaemoon Lee, Jae Hun Kim
BACKGROUND: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. METHODS: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28416994/the-radiation-safety-education-and-the-pain-physicians-efforts-to-reduce-radiation-exposure
#14
Tae Hee Kim, Seung Wan Hong, Nam Sik Woo, Hae Kyoung Kim, Jae Hun Kim
BACKGROUND: C-arm fluoroscopy equipment is important for interventional pain management and can cause radiation injury to physicians and patients. We compared radiation safety education and efforts to reduce the radiation exposure of pain specialists. METHODS: A survey of 49 pain specialists was conducted anonymously in 2016. The questionnaire had 16 questions. That questionnaire was about radiation safety knowledge and efforts to reduce exposure. We investigated the correlation between radiation safety education and efforts of radiation protection...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#15
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416036/exploring-dementia-management-attitudes-in-primary-care-a-key-informant-survey-to-primary-care-physicians-in-25-european-countries
#16
Ferdinando Petrazzuoli, Shlomo Vinker, Tuomas H Koskela, Thomas Frese, Nicola Buono, Jean Karl Soler, Jette Ahrensberg, Radost Asenova, Quintí Foguet Boreu, Gülsen Ceyhun Peker, Claire Collins, Miro Hanževački, Kathryn Hoffmann, Claudia Iftode, Donata Kurpas, Jean Yves Le Reste, Bjørn Lichtwarck, Davorina Petek, Daniel Pinto, Diego Schrans, Sven Streit, Eugene Yee Hing Tang, Athina Tatsioni, Péter Torzsa, Pemra C Unalan, Harm van Marwijk, Hans Thulesius
BACKGROUND: Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment...
April 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28415977/perspectives-of-frailty-and-frailty-screening-protocol-for-a-collaborative-knowledge-translation-approach-and-qualitative-study-of-stakeholder-understandings-and-experiences
#17
Mandy M Archibald, Rachel Ambagtsheer, Justin Beilby, Mellick J Chehade, Tiffany K Gill, Renuka Visvanathan, Alison L Kitson
BACKGROUND: Accompanying the unprecedented growth in the older adult population worldwide is an increase in the prevalence of frailty, an age-related clinical state of increased vulnerability to stressor events. This increased vulnerability results in lower social engagement and quality of life, increased dependency, and higher rates of morbidity, health service utilization and mortality. Early identification of frailty is necessary to guide implementation of interventions to prevent associated functional decline...
April 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28411323/practice-patterns-for-the-prophylaxis-and-treatment-of-acute-radiation-dermatitis-in-the-united-states
#18
Patricia Lucey, Christos Zouzias, Loren Franco, Sravana K Chennupati, Shalom Kalnicki, Beth N McLellan
PURPOSE: Due to the inconclusive evidence for available treatment options, management of radiation dermatitis (RD) varies among practitioners. This study defines and reviews the current treatment patterns for RD in the USA, providing guidance for practicing physicians as well as directions for future research. METHODS: An online survey of 21 questions was emailed to all 5626 members of the 2013 American Society for Radiation Oncology (ASTRO) directory, which included radiation oncologists, residents, fellows, physician assistants, nurse practitioners, registered nurses and other care providers...
April 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28411137/gospel-3-management-of-gout-by-primary-care-physicians-and-office-based-rheumatologists-in-france-in-the-early-21-st-century-comparison-with-2006-eular-recommendations
#19
Julia Goossens, Sylvie Lancrenon, Sabine Lanz, Hang-Korng Ea, Charles Lambert, Pascal Guggenbuhl, Alain Saraux, Catherine Delva, Samy Sahbane, Frédéric Lioté
INTRODUCTION: In 2006, recommendations about the management of gout were issued by the EUropean League Against Rheumatism (EULAR). The objective of this work was to compare these recommendations to practice patterns of physicians working in private practices in France. METHOD: In a prospective multicenter nationwide study conducted in France, a random sample of primary-care physicians (PCPs) and private-practice rheumatologists (PPRs) was taken in 2009. Each physician included 2 consecutive patients with gout...
April 11, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28411013/physician-reported-factors-that-encourage-collaboration-with-community-pharmacists
#20
Nicole C Pezzino, Macary Weck Marciniak, Megan G Smith, Stefanie P Ferreri
OBJECTIVE: To determine factors that encourage physicians to establish collaborative practice agreements with community pharmacists. METHODS: A 20-item cross-sectional survey was mailed to a random sample of 1000 family medicine physicians practicing in North Carolina. Two weeks after the initial mailing, a reminder was sent to physicians. Physicians were entered into a drawing to receive a gift card as an incentive for survey completion. The questionnaire collected demographic information, factors important to physicians for collaboration with a community pharmacist, and physician perceptions of pharmacist qualifications...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
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