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https://www.readbyqxmd.com/read/29792519/effects-of-online-physician-reviews-and-physician-gender-on-perceptions-of-physician-skills-and-primary-care-physician-pcp-selection
#1
Siyue Li, Roselyn J Lee-Won, Jessica McKnight
Physician review websites have become more relevant and important in people's selection of physicians. The current study experimentally examined how online physician reviews endorsing a primary care physician's (PCP's) technical or interpersonal skills, along with a physician's gender, may influence people's perceptions of the physician's skills and their willingness to choose the physician. Participants were randomly assigned to view a mockup physician review web page and to imagine that they needed to find a new PCP in a new city...
May 24, 2018: Health Communication
https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#2
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29791671/validation-of-a-moral-distress-instrument-in-nurses-of-primary-health-care
#3
Priscila Orlandi Barth, Flávia Regina Souza Ramos, Edison Luiz Devos Barlem, Graziele de Lima Dalmolin, Dulcinéia Ghizoni Schneider
OBJECTIVE: to validate an instrument to identify situations that trigger moral distress in relation to intensity and frequency in primary health care nurses. METHOD: this is a methodological study carried out with 391 nurses of primary health care, applied to the Brazilian Scale of Moral Distress in Nurses with 57 questions. Validation for primary health care was performed through expert committee evaluation, pre-test, factorial analysis, and Cronbach's alpha. RESULTS: there were 46 questions validated divided into six constructs: Health Policies, Working Conditions, Nurse Autonomy, Professional ethics, Disrespect to patient autonomy and Work Overload...
2018: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29791190/the-comprehensive-primary-care-initiative-effects-on-spending-quality-patients-and-physicians
#4
Deborah Peikes, Stacy Dale, Arkadipta Ghosh, Erin Fries Taylor, Kaylyn Swankoski, Ann S O'Malley, Timothy J Day, Nancy Duda, Pragya Singh, Grace Anglin, Laura L Sessums, Randall S Brown
The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices...
May 23, 2018: Health Affairs
https://www.readbyqxmd.com/read/29790923/missed-opportunities-to-prescribe-preexposure-prophylaxis-in-south-carolina-2013-2016
#5
Dawn K Smith, Man-Huei Chang, Wayne A Duffus, Stella Okoye, Sharon Weissman
Introduction: Expanding use of preexposure prophylaxis (PrEP) in ways that address current racial/ethnic disparities is an important HIV prevention goal. We investigated missed opportunities to provide PrEP during healthcare visits occurring prior to HIV infection. Methods: This retrospective cohort study linked South Carolina HIV case surveillance data to 3 statewide healthcare databases. Characteristics of patients, health care visits and providers, sexually transmitted diseases (STD), and other diagnoses, were assessed for medical encounters occurring before an initial HIV diagnosis...
May 22, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29790864/implementing-comprehensive-primary-care-referral-tracking-in-a-patient-centered-medical-home
#6
Jenny Spahr, Jennifer Coddington, Nancy Edwards, Sara McComb
The Patient-Centered Medical Home care model emphasizes efficient, coordinated care distributed among interdisciplinary team members. One key function to care coordination is referral/test tracking. This study evaluated the referral practices in a nurse-managed Patient-Centered Medical Home primary care clinic. The major findings corroborate the need for a well-organized referral-tracking system that is centralized and contains safety nets to reduce the number of delayed or missed referrals.
July 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29789607/point-of-care-microspirometry-to-facilitate-the-copd-diagnostic-process-in-primary-care-a-clustered-randomised-trial
#7
Tjard R Schermer, Maria Vatsolaki, Robbert Behr, Joke Grootens, Riet Cretier, Reinier Akkermans, Joke Denis, Patrick Poels, Lisette van den Bemt
We studied if pre-bronchodilator FEV1 /FEV6 determinations with microspirometers by GPs improve the diagnostic process for COPD in a 6-8 month clustered randomised controlled trial in Dutch general practices ( http://www.trialregister.nl : NTR4041). GPs allocated to microspirometry (MI) used COPD-6® microspirometers in patients ≥50 years old with a smoking history and respiratory complaints that could indicate undiagnosed COPD and ask to refer patients for full spirometry if MI was positive (FEV1 /FEV6 <0...
May 22, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#8
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29788914/nutrition-care-practices-of-primary-care-providers-for-weight-management-in-multidisciplinary-primary-care-settings-in-ontario-canada-a-qualitative-study
#9
Stephanie Aboueid, Ivy Bourgeault, Isabelle Giroux
BACKGROUND: Despite the recommended guidelines on addressing diet for the management and prevention of obesity in primary care, the literature highlights that their implementation has been suboptimal. In this paper, we provide an in-depth understanding of current nutrition-related weight management practices of primary care providers (PCPs) working in relatively new multidisciplinary health care settings in Ontario. METHODS: Three types of multidisciplinary primary care settings were included (2 Family Health Teams, 3 Community Health Centres and 1 Nurse Practitioner-Led Clinic)...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788908/perceptions-of-insulin-use-in-type-2-diabetes-in-primary-care-a-thematic-synthesis
#10
Kathy Ellis, Henrietta Mulnier, Angus Forbes
BACKGROUND: Increasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788906/influences-on-the-adoption-of-patient-safety-innovation-in-primary-care-a-qualitative-exploration-of-staff-perspectives
#11
Ian Litchfield, Paramjit Gill, Tony Avery, Stephen Campbell, Katherine Perryman, Kate Marsden, Sheila Greenfield
BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788350/relationship-among-team-dynamics-care-coordination-and-perception-of-safety-culture-in-primary-care
#12
Karen J Blumenthal, Alyna T Chien, Sara J Singer
Background: There remains a need to improve patient safety in primary care settings. Studies have demonstrated that creating high-performing teams can improve patient safety and encourage a safety culture within hospital settings, but little is known about this relationship in primary care. Objective: To examine how team dynamics relate to perceptions of safety culture in primary care and whether care coordination plays an intermediating role. Research Design: This is a cross-sectional survey study with 63% response (n = 1082)...
May 18, 2018: Family Practice
https://www.readbyqxmd.com/read/29788258/is-the-plasma-aldosterone-to-renin-ratio-associated-with-blood-pressure-response-to-treatment-in-general-practice
#13
Sabine C Käyser, Bianca W M Schalk, Wim J C de Grauw, Tjard R Schermer, Reinier P Akkermans, Jacques W M Lenders, Jaap Deinum, Marion C J Biermans
Background: Individualized antihypertensive treatment based on specific biomarkers such as renin may lead to more effective blood pressure control in patients with newly diagnosed essential hypertension. Recent studies suggested that the plasma aldosterone-to-renin ratio (ARR) may also be a candidate predictor for this purpose. Objective: To assess whether the ARR is associated with the blood pressure response to antihypertensive treatment in patients with newly diagnosed hypertension...
May 19, 2018: Family Practice
https://www.readbyqxmd.com/read/29788253/effectiveness-of-a-blended-physical-therapist-intervention-in-people-with-hip-osteoarthritis-knee-osteoarthritis-or-both-a-cluster-randomized-controlled-trial
#14
Corelien J J Kloek, Daniël Bossen, Peter M Spreeuwenberg, Joost Dekker, Dinny H de Bakker, Cindy Veenhof
Background: Integrating physical therapy sessions and an online application (e-Exercise) might support people with hip osteoarthritis (OA), knee OA, or both (hip/knee OA) in taking an active role in the management of their chronic condition and may reduce the number of physical therapy sessions. Objective: The objective of this study was to investigate the short- and long-term effectiveness of e-Exercise compared to usual physical therapy in people with hip/knee OA...
May 17, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29788110/long-term-compliance-with-a-validated-intravenous-insulin-therapy-protocol-in-cardiac-surgery-patients-a-quality-improvement-project
#15
Guillaume Besch, Andrea Perrotti, Lucie Salomon du Mont, Raphaelle Tucella, Guillaume Flicoteaux, Aline Bondy, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
Quality problem: Safe and efficient blood glucose (BG) level control after cardiac surgery relies on an intensive care unit (ICU) team-based approach, including implementation of a dynamic insulin therapy protocol (ITP). Long-term compliance with such a complex protocol is poorly addressed in the literature. The aim of this study was to assess the long-term compliance of nurses with the ITP, 7 years after its implementation in the ICU. Initial assessment: A professional practice evaluation, integrated in a process of quality improvement program, was retrospectively conducted on 224 consecutive cardiac surgery patients over a 6-month period (PHASE 1)...
May 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29788036/pediatric-investigators-collaborative-network-on-infections-in-canada-picnic-study-of-respiratory-syncytial-virus-associated-deaths-in-pediatric-patients-in-canada-2003-to-2013
#16
Jennifer Tam, Jesse Papenburg, Sergio Fanella, Sandra Asner, Michelle Barton, Cybele Bergeron, Shalini Desai, Charles Hui, Cheryl Foo, Joanne M Langley, Kirk Leifso, My-Linh Ma, Jeffrey Pernica, Joan Robinson, Roopi Singh, Bruce Tapiero, Upton Allen
Background: Respiratory syncytial virus (RSV) is a major cause of pneumonia and bronchiolitis in children. Mortality rates in previously healthy children hospitalized with RSV are < 0.5%, but up to 37% in patients with underlying medical conditions. The objective of this study was to characterize factors associated with deaths among children hospitalized with RSV infection in Canadian pediatric centres. Methods: Retrospective case series of children 18 years of age or younger with RSV-associated deaths at centres affiliated with the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) over the period 2003- 2013, inclusive...
May 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29787684/trends-and-variation-in-prescribing-of-low-priority-treatments-identified-by-nhs-england-a-cross-sectional-study-and-interactive-data-tool-in-english-primary-care
#17
Alex J Walker, Helen J Curtis, Seb Bacon, Richard Croker, Ben Goldacre
Objectives NHS England recently announced a consultation seeking to discourage the use of treatments it considers to be low-value. We set out to produce an interactive data resource to show savings in each NHS general practice and to assess the current use of these treatments, their change in use over time, and the extent and reasons for variation in such prescribing. Design Cross-sectional analysis. Setting English primary care. Participants English general practices. Main outcome measures We determined the cost per 1000 patients for prescribing of each of 18 treatments identified by NHS England for each month from July 2012 to June 2017, and also aggregated over the most recent year to assess total cost and variation among practices...
January 1, 2018: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/29787555/implementation-of-a-ct-scan-practice-guideline-for-pediatric-trauma-patients-reduces-unnecessary-scans-without-impacting-outcomes
#18
Patrick R McGrew, Paul J Chestovich, Jay D Fisher, Deborah A Kuhls, Douglas R Fraser, Purvi P Patel, Chad W Katona, Syed Saquib, John J Fildes
INTRODUCTION: Computed Tomography (CT) scans are useful in the evaluation of trauma patients, but are costly and pose risks from ionizing radiation in children. Recent literature has demonstrated the utility of CT scan guidelines in the management of pediatric trauma. This study objective is to review our treatment of pediatric blunt trauma patients and evaluate CT utilization before and after CT-guideline implementation. METHODS: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787513/real-time-ultrasound-assisted-gluteal-fat-grafting
#19
Alvaro Luiz Cansancao, Alexandra Condé-Green, Rafael A Vidigal, Ricardo Luis Rodriguez, Richard A D'Amico
BACKGROUND: Outcomes in primary breast augmentation depend on careful preoperative planning and clear communication between patient and surgeon. Three-dimensional imaging with computer simulation is an evolving technology with the potential to enhance the preoperative consultation for patients considering primary breast augmentation. The purpose of this study was to prospectively evaluate the impact of three-dimensional imaging with computer simulation on patient-reported and objective, mammometric outcomes in women undergoing primary breast augmentation...
May 16, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29785890/family-networks-and-healthy-behaviour-evidence-from-nepal
#20
Jolene Skordis, Noemi Pace, Marcos Vera-Hernandez, Imran Rasul, Emla Fitzsimons, David Osrin, Dharma Manandhar, Anthony Costello
Models of household decision-making commonly focus on nuclear family members as primary decision-makers. If extended families shape the objectives and constraints of households, then neglecting the role of this network may lead to an incomplete understanding of health-seeking behaviour. Understanding the decision-making processes behind care-seeking may improve behaviour change interventions, better intervention targeting and support health-related development goals. This paper uses data from a cluster randomised trial of a participatory learning and action cycle (PLA) through women's groups, to assess the role of extended family networks as a determinant of gains in health knowledge and health practice...
May 22, 2018: Health Economics, Policy, and Law
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