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https://www.readbyqxmd.com/read/27932252/changes-in-primary-care-provision-in-turkey-a-comparison-of-1993-and-2012
#1
Mehmet Akman, Sibel Sakarya, Mehmet Sargın, İlhami Ünlüoğlu, Memet Taşkın Eğici, Wienke G W Boerma, Willemijn L A Schäfer
Since the early 1990s, the primary care system in Turkey has undergone fundamental changes. In the first decade of the millennium family doctor scheme was introduced to the Turkish primary care sector and the name of the primary care doctors (PCDs) changed from "general practitioner" (GP) to "family doctor" (FD). This study aims to give an insight into those changes and to compare the service profiles of PCDs in 1993 and 2012. Data, based on cross sectional surveys among Turkish doctors working in primary care are derived from the 1993 European GP Task Profile study (n=199) and the 2012 Quality and Costs of Primary Care in Europe (QUALICOPC) study (n=299)...
December 5, 2016: Health Policy
https://www.readbyqxmd.com/read/27930803/pulmonary-rehabilitation-following-exacerbations-of-chronic-obstructive-pulmonary-disease
#2
REVIEW
Milo A Puhan, Elena Gimeno-Santos, Christopher J Cates, Thierry Troosters
BACKGROUND: Guidelines have provided positive recommendations for pulmonary rehabilitation after exacerbations of chronic obstructive pulmonary disease (COPD), but recent studies indicate that postexacerbation rehabilitation may not always be effective in patients with unstable COPD. OBJECTIVES: To assess effects of pulmonary rehabilitation after COPD exacerbations on hospital admissions (primary outcome) and other patient-important outcomes (mortality, health-related quality of life (HRQL) and exercise capacity)...
December 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27929247/initial-management-of-patients-with-hiv-infection
#3
Ronald H Goldschmidt, Carolyn Chu, Betty J Dong
Human immunodeficiency virus (HIV) infection has become a treatable chronic disease with near-normal life expectancy when patients receive antiretroviral therapy (ART). Family physicians and other primary care clinicians commonly provide long-term comprehensive care for persons with HIV infection. This article describes the scope of initial care, including obtaining a thorough history; physical examination for HIV-associated manifestations; attention to HIV-specific immunization schedules; routine and HIV-specific laboratory evaluation; and ensuring standard health care maintenance to prevent HIV- and non-HIV-related morbidity and mortality...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27927587/estimated-gfr-before-and-after-bariatric-surgery-in-ckd
#4
Talha H Imam, Heidi Fischer, Bocheng Jing, Raoul Burchette, Shayna Henry, Stephen F DeRose, Karen J Coleman
BACKGROUND: Several reviews have recently detailed the beneficial effects of weight loss surgery for kidney function. However, these studies have a number of limitations, including small sample size, few done in chronic kidney disease (CKD) stages 3 and 4, and many not including the main bariatric surgery procedures used in the United States today. STUDY DESIGN: This was an observational retrospective cohort study comparing propensity score-matched bariatric surgery patients and nonsurgery control patients who were referred for, but did not have, surgery...
December 4, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27926621/accountable-care-organization-implementation-experiences-and-rural-participation-considerations-for-nurses
#5
Matt Thomas Bagwell, Angeline Bushy, Judith Ortiz
BACKGROUND: Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). METHODS: Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27925017/community-health-workers-perceptions-in-relation-to-speech-and-language-disorders
#6
Carla Cristina Lins Santos Knochenhauer, Karina Mary de Paiva Vianna
Purpose: To know the perception of the Community Health Workers (CHW) about the speech and language disorders. Method: Cross-sectional study, which involved a questionnaire with questions related to the knowledge of CHW on speech and language disorders. The research was carried out with CHW allocated in the Centro Sanitary District of Florianópolis. Results: We interviewed 35 CHW, being mostly (80%) female gender, with a average age of 47 years (standard deviation = 2...
December 1, 2016: CoDAS
https://www.readbyqxmd.com/read/27923343/feasibility-and-cost-effectiveness-of-a-multidisciplinary-home-telehealth-intervention-programme-to-reduce-falls-among-elderly-discharged-from-hospital-study-protocol-for-a-randomized-controlled-trial
#7
Alessandro Giordano, Gian Pietro Bonometti, Fabio Vanoglio, Mara Paneroni, Palmira Bernocchi, Laura Comini, Amerigo Giordano
BACKGROUND: Fall incidents are the third cause of chronic disablement in elderly according to the World Health Organization (WHO). Recent meta-analyses shows that a multifactorial falls risk assessment and management programmes are effective in all older population studied. However, the application of these programmes may not be the same in all National health care setting and, consequently, needs to be evaluated by cost-effectiveness studies before to plan this intervention in regular care...
December 7, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27922780/community-matrons-as-problem-solvers-for-people-living-with-multi-co-morbid-disease
#8
Sue Randall, Colin Thunhurst, Gill Furze
Working with patients in their own homes gives community matrons an advantage of seeing patients in the context of their everyday lives. This allows comprehensive assessment of need with an aim of promoting health or promoting stability for people living with chronic disease. Complex issues are resolved through problem-solving and this can result in patients being maintained in their own homes and thus in reduced unplanned hospitalisation. Data were collected from participants using semi-structured interviews and audio diaries...
December 2, 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27922028/a-randomized-double-blind-placebo-controlled-trial-to-examine-the-effectiveness-of-lubiprostone-on-constipation-symptoms-and-colon-transit-time-in-diabetic-patients
#9
Jennifer Christie, Sagar Shroff, Nikrad Shahnavaz, Latoya A Carter, Melanie S Harrison, Karan A Dietz-Lindo, John Hanfelt, Shanthi Srinivasan
OBJECTIVES: Constipation is the most common GI symptom in patients with diabetes mellitus (DM). Importantly, patients with constipation have lower health-related quality of life than those without constipation. Effective therapies for constipation are limited and there is a paucity of data evaluating the treatment of constipation in diabetics. METHODS: Diabetic patients with chronic idiopathic constipation (CIC) as defined by Rome III criteria were recruited from outpatient clinics at a tertiary-care center and a Veterans Administration Hospital...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921360/mortality-in-patients-who-discontinue-low-dose-acetylsalicylic-acid-therapy-after-upper-gastrointestinal-bleeding
#10
Antonio González-Pérez, María Eugenia Sáez, Saga Johansson, Péter Nagy, Luis A García Rodríguez
PURPOSE: Discontinuing low-dose acetylsalicylic acid (ASA) therapy after upper gastrointestinal bleeding (UGIB) may increase the risk of cardiovascular-related death. Our aim was to compare mortality in UK primary care patients who discontinue ASA after UGIB with that in patients who continue therapy. METHODS: ASA users at the time of UGIB and who were alive 30 days after were selected using The Health Improvement Network. Predictors of survival were assessed using adjusted Cox proportional hazards regression models...
December 6, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27920578/recording-of-hospitalizations-for-acute-exacerbations-of-copd-in-uk-electronic-health-care-records
#11
Kieran J Rothnie, Hana Müllerová, Sara L Thomas, Joht S Chandan, Liam Smeeth, John R Hurst, Kourtney Davis, Jennifer K Quint
BACKGROUND: Accurate identification of hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) within electronic health care records is important for research, public health, and to inform health care utilization and service provision. We aimed to develop a strategy to identify hospitalizations for AECOPD in secondary care data and to investigate the validity of strategies to identify hospitalizations for AECOPD in primary care data. METHODS: We identified patients with chronic obstructive pulmonary disease (COPD) in the Clinical Practice Research Datalink (CPRD) with linked Hospital Episodes Statistics (HES) data...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27920470/nonalcoholic-fatty-liver-disease-a-multisystem-disease
#12
REVIEW
Ivana Mikolasevic, Sandra Milic, Tamara Turk Wensveen, Ivana Grgic, Ivan Jakopcic, Davor Stimac, Felix Wensveen, Lidija Orlic
Non-alcoholic fatty liver disease (NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome (MetS). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of MetS...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27920303/the-dental-medical-divide
#13
Elizabeth A Mertz
The importance of oral health for overall well-being cannot be overstated. Yet the US dental delivery system struggles to address effectively the two most common oral diseases (caries and periodontal disease), which are among the most prevalent of all chronic diseases and are largely preventable. This article describes the evolution of contemporary US dental care policy and practice, highlighting the challenges resulting from the dental system's separation from the rest of health care, and explores the implications of this divide for the future of oral health policy and system reform...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920119/randomized-trial-to-reduce-emergency-visits-or-hospital-admissions-using-telephone-coaching-to-complex-patients
#14
María González-Ortega, Joan Gené-Badia, Belchin Kostov, Vicente García-Valdecasas, Carmen Pérez-Martín
BACKGROUND: Comorbidity remains a matter of international interest, given growing prevalence of chronic conditions. OBJECTIVE: To evaluate the impact that adding a telephone coaching intervention by a family physician to usual care has on reducing resource consumption and improving health status, caregiver burden and quality of life among complex chronic patients (CCP) compared with usual care. METHODS: A randomized controlled trial was conducted on a random sample of CCP from three primary care teams in Barcelona...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27919369/informing-the-development-of-an-internet-based-chronic-pain-self-management-program
#15
Amédé Gogovor, Regina Visca, Claudine Auger, Lucie Bouvrette-Leblanc, Iphigenia Symeonidis, Lise Poissant, Mark A Ware, Yoram Shir, Natacha Viens, Sara Ahmed
BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27917014/contextual-ecological-and-organizational-variations-in-risk-adjusted-copd-and-asthma-hospitalization-rates-of-rural-medicare-beneficiaries
#16
Thomas T H Wan, Yi-Ling Lin, Judith Ortiz
The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling...
2016: Research in the Sociology of Health Care
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#17
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27911073/reducing-risky-alcohol-use-what-health-care-systems-can-do
#18
Amity E Quinn, Mary Brolin, Maureen T Stewart, Brooke Evans, Constance Horgan
Risky, non-dependent alcohol use is prevalent in the United States, affecting 25% of adults (Centers for Disease Control and Prevention, 2014b). Massachusetts has higher rates of alcohol use and binge drinking than most states (Substance Abuse and Mental Health Services Administration, 2015). Serious physical, social, and economic consequences result. Excessive alcohol use contributes to cancer, cardiovascular disease, sleep disorders, birth defects, motor vehicle injuries, and suicide, and it complicates management of chronic illnesses (Green, McKnight-Eily, Tan, Mejia, & Denny, 2016; Laramee et al...
April 27, 2016: Issue Brief
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#19
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27909877/association-between-mental-health-staffing-level-and-primary-care-mental-health-integration-level-on-provision-of-depression-care-in-veteran-s-affairs-medical-facilities
#20
Denise C Cooper, Christian D Helfrich, Stephen M Thielke, Ranak B Trivedi, Karin M Nelson, Gayle E Reiber, Evercita C Eugenio, Kristine Beaver, Julie Nugent-Carney, Vincent S Fan
We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1...
December 1, 2016: Administration and Policy in Mental Health
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