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https://www.readbyqxmd.com/read/28550930/real-time-mobile-device-assisted-chest-compression-during-cardiopulmonary-resuscitation
#1
Satyam Sarma, Hakiza Bucuti, Anurag Chitnis, Alex Klacman, Ram Dantu
Prompt administration of high-quality cardiopulmonary resuscitation (CPR) is a key determinant of survival from cardiac arrest. Strategies to improve CPR quality at point of care could improve resuscitation outcomes. We tested whether a low cost and scalable mobile phone- or smart watch-based solution could provide accurate measures of compression depth and rate during simulated CPR. Fifty health care providers (58% intensive care unit nurses) performed simulated CPR on a calibrated training manikin (Resusci Anne, Laerdal) while wearing both devices...
May 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#2
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550349/choice-of-repairing-inguinal-hernia-in-children-open-versus-laparoscopy
#3
Venkatachalam Raveenthiran, Prakash Agarwal
Inguinal hernia is a common disorder of childhood that requires surgical repair at diagnosis. Traditionally, it is operated upon by open inguinal incision. However, with the introduction of laparoscopic repair in 1990, opinion of scientific community is divided concerning the best method of pediatric herniotomy. Educated parents, who long to have the choicest of the best, often gather information from internet and prefer to discuss their concerns with primary care physicians. This descriptive review is intended to provide practicing pediatricians with updated evidence-based information which will enable them to counsel parents regarding the choice of hernia repair...
May 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28550024/chest-pain-and-shortness-of-breath-in-cardiovascular-disease-a-prospective-cohort-study-in-uk-primary-care
#4
Lauren A Barnett, James A Prior, Umesh T Kadam, Kelvin P Jordan
OBJECTIVE: To determine characteristics associated with monthly chest pain and shortness of breath (SoB) during activity in cardiovascular disease (CVD) and trajectories of these symptoms over 10 months. STUDY DESIGN AND SETTING: Baseline questionnaire was sent to patients aged ≥40 years from 10 UK general practices. Responders were sent monthly questionnaires for 10 months. For patients with CVD (ischaemic heart disease and heart failure), the association of sociodemographic characteristics, pain elsewhere and anxiety and depression with monthly reports of chest pain and SoB during activity were determined using multilevel, multinomial logistic regression...
May 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28549800/the-active-implementation-frameworks-a-roadmap-for-advancing-implementation-of-comprehensive-medication-management-in-primary-care
#5
Carrie Blanchard, Melanie Livet, Caryn Ward, Lindsay Sorge, Todd D Sorensen, Mary Roth McClurg
Implementation of evidence-based health services interventions is complex and often limited in scope. The Active Implementation Frameworks (AIFs) are an evidence-based set of frameworks to use when attempting to put into practice any innovation of known dimensions. This article describes the novel application of the AIFs to facilitate the implementation and improvement of Comprehensive Medication Management (CMM) in primary care practices to optimize medication use and improve care for patients.
May 22, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28549789/systematic-approaches-to-adverse-events-in-obstetrics-part-i-event-identification-and-classification
#6
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
May 23, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28549563/no-346-advanced-reproductive-age-and-fertility
#7
Kimberly E Liu, Allison Case
OBJECTIVE: To improve awareness of the natural age-related decline in female and male fertility with respect to natural fertility and assisted reproductive technologies (ART), provide recommendations for their management, and to review investigations in the assessment of ovarian aging. OPTIONS: This guideline reviews options for the assessment of ovarian reserve and fertility treatments using ART with women of advanced reproductive age presenting with infertility...
May 23, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28549460/learning-to-use-electronic-health-records-can-we-stay-patient-centered-a-pre-post-intervention-study-with-family-medicine-residents
#8
Cédric Lanier, Melissa Dominicé Dao, Patricia Hudelson, Bernard Cerutti, Noëlle Junod Perron
BACKGROUND: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the "patient-centered" use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. The aim of this study was to assess the impact of training on residents' EHR-related communication skills and explore whether they varied according to the content of the consultation...
May 26, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28549015/early-oral-feeding-following-mckeown-minimally-invasive-esophagectomy-an-open-label-randomized-controlled-noninferiority-trial
#9
Hai-Bo Sun, Yin Li, Xian-Ben Liu, Rui-Xiang Zhang, Zong-Fei Wang, Toni Lerut, Chia-Chuan Liu, Alfonso Fiorelli, Yin-Kai Chao, Daniela Molena, Robert J Cerfolio, Soji Ozawa, Andrew C Chang
OBJECTIVE: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. SUMMARY BACKGROUND DATA: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. METHODS: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548896/implementation-of-asthma-clinical-practice-guidelines-in-primary-care-a-cross-sectional-study-based-on-the-knowledge-to-action-cycle
#10
Myriam E Gagné, Louis-Philippe Boulet
OBJECTIVE: Based on the Knowledge-to-Action Cycle, we assessed the self-reported implementation and perception of asthma clinical practice guideline (CPG) recommendations in primary care physicians (PCPs), along with the barriers and facilitators to CPG use in primary care. METHODS: We conducted a cross-sectional study. Using the extended Asthma Physicians' Practice Assessment Questionnaire(©), PCPs self-reported the following: their knowledge of 15 key asthma CPG recommendations, the perceived usefulness of each of these recommendations, their motivation to apply these recommendations, and their agreement with the content of these recommendations...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28547563/poor-adherence-to-national-clinical-management-guidelines-a-population-based-cross-sectional-study-of-the-surgical-management-of-melanoma-in-new-south-wales-australia
#11
Alexander H R Varey, Christine M Madronio, Anne E Cust, Chris Goumas, Graham J Mann, Bruce K Armstrong, Richard A Scolyer, Austin M Curtin, John F Thompson
BACKGROUND: Standardization of the clinical management of melanoma through the formulation of national guidelines, based on interpretation of the existing evidence and consensus expert opinion, seeks to improve quality of care; however, adherence to national guidelines has not been well studied. METHODS: A population-based, cross-sectional study of the clinical management of all patients with newly notified primary melanomas in the state of New South Wales, Australia, during 2006/2007 was conducted using cancer registry identification and questionnaires completed by treating physicians...
May 25, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28547268/primary-care-providers-experience-management-and-referral-patterns-regarding-pelvic-floor-disorders-a-national-survey
#12
Donna Mazloomdoost, Catrina C Crisp, Steven D Kleeman, Rachel N Pauls
INTRODUCTION AND HYPOTHESIS: Primary care physicians can impact womens' access to care. We assessed primary care providers' experience and management regarding pelvic floor disorders. METHODS: This Institutional Review Board approved study invited internal and family Medicine Program Directors to complete and distribute to faculty an online survey designed to query demographics, perceptions, management, and referral patterns regarding urinary incontinence (UI), overactive bladder (OAB), and pelvic organ prolapse (POP) in females...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28546591/the-healthcare-system-and-the-provision-of-oral-healthcare-in-european-union-member-states-part-8-italy
#13
M Bindi, C Paganelli, K A Eaton, E Widström
In Italy healthcare is provided for all Italian citizens and residents and it is delivered mainly by public providers, with some private or private-public entities. Italy's public healthcare system - the Servizio Sanitario Nazionale (SSN) - is organised by the Ministry of Health and administered on a devolved regional basis. It is financed by general taxation that provides universal coverage, largely free of charge at the point of service. The central government establishes the basic national health benefits package, which must be uniformly provided throughout the country, through services guaranteed under the NHS provision called LEA - (Livelli Essenziali di Assistenza [Essential Level of Assistance]) and allocates national funds to the regions...
May 26, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28545740/-factors-associated-with-primary-care-professionals-readiness-to-respond-to-intimate-partner-violence-in-spain
#14
Pilar Murillo, Miguel San Sebastián, Carmen Vives-Cases, Isabel Goicolea
OBJECTIVE: To analyse the Spanish primary care professionals' readiness to respond to intimate partner violence (IPV) in primary care and identify possible determinants that could facilitate a better response. METHOD: A cross-sectional study with a non-probabilistic sampling by convenience was performed among healthcare professionals working in 15 primary care centres in Spain. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), the version validated and translated into Spanish, was the instrument used to collect information about knowledge, opinions and practices regarding intimate partner violence...
May 22, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#15
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545535/electronic-audit-and-feedback-intervention-with-action-implementation-toolbox-to-improve-pain-management-in-intensive-care-protocol-for-a-laboratory-experiment-and-cluster-randomised-trial
#16
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Evert de Jonge, Niels Peek, Dave A Dongelmans, Nicolette F de Keizer
BACKGROUND: Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545493/three-approaches-to-glucose-monitoring-in-non-insulin-treated-diabetes-a-pragmatic-randomized-clinical-trial-protocol
#17
Laura A Young, John B Buse, Mark A Weaver, Maihan B Vu, April Reese, C Madeline Mitchell, Tamara Blakeney, Kimberlea Grimm, Jennifer Rees, Katrina E Donahue
BACKGROUND: For the nearly 75% of patients living with type 2 diabetes (T2DM) that do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) can be especially problematic. While in theory SMBG holds great promise for sparking favorable behavior change, it is a resource intensive activity without firmly established patient benefits. This study describes our study protocol to assess the impact of three different SMBG testing approaches on patient-centered outcomes in patients with non-insulin treated T2DM within a community-based, clinic setting...
May 25, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28545412/how-do-population-general-practice-and-hospital-factors-influence-ambulatory-care-sensitive-admissions-a-cross-sectional-study
#18
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK and other healthcare systems, however it remains uncertain how this can be achieved. This paper explores the relationship between unplanned ambulatory care sensitive condition (ACSC) admission rates and population, general practice and hospital characteristics. Additionally, we investigated if these factors had a differential impact across 28 conditions. METHODS: We used the English Hospital Episode Statistics to calculate the number of unplanned ACSC hospital admissions for 28 conditions at 8,029 general practices during 2011/12...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28545402/regional-variations-of-perceived-problems-in-ambulatory-care-from-the-perspective-of-general-practitioners-and-their-patients-an-exploratory-focus-group-study-in-urban-and-rural-regions-of-northern-germany
#19
H Hansen, N J Pohontsch, L Bole, I Schäfer, M Scherer
BACKGROUND: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS: We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28545038/assessing-the-facilitators-and-barriers-of-interdisciplinary-team-working-in-primary-care-using-normalisation-process-theory-an-integrative-review
#20
Pauline O'Reilly, Siew Hwa Lee, Madeleine O'Sullivan, Walter Cullen, Catriona Kennedy, Anne MacFarlane
BACKGROUND: Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps...
2017: PloS One
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