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https://www.readbyqxmd.com/read/28738423/continued-statin-prescriptions-after-adverse-reactions-and-patient-outcomes-a-cohort-study
#1
Huabing Zhang, Jorge Plutzky, Maria Shubina, Alexander Turchin
Background: Many patients discontinue statin treatment, often after having a possible adverse reaction. The risks and benefits of continued statin therapy after an adverse reaction are not known. Objective: To examine the relationship between continuation of statin therapy (any prescription within 12 months after an adverse reaction) and clinical outcomes. Design: Retrospective cohort study. Setting: Primary care practices affiliated with 2 academic medical centers...
July 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#2
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#3
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737984/evaluating-the-training-responsibilities-and-practices-of-p-t-committee-members-and-nonmember-contributors
#4
Ryan Rodriguez, Brett J Kelly, Mary Moody
BACKGROUND: Pharmacy and therapeutics (P&T) committees are responsible for managing drug formularies in numerous health care settings. Although pharmacy practice and health care organizations provide general recommendations of responsibilities and skills for members and nonmember contributors of P&T committees, the study investigators hypothesized that there is diversity in the training, responsibilities, and practices of these members and contributors. OBJECTIVE: To describe the training, responsibilities, and practices of members and nonmember contributors of P&T committees in a variety of health care settings, using an online survey...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737648/who-is-responsible-for-what-happens-before-during-and-after-colonoscopy-results-of-a-national-survey-of-primary-care-physicians
#5
Andrew J Read, Arlene Weissman, Philip S Schoenfeld, Seema Saini, Stacy B Menees, Sameer D Saini
BACKGROUND AND AIMS: Primary care providers (PCPs) play a critical role in colon cancer screening by initiating referrals to gastroenterologists for colonoscopy, but little is known about their role in pre-colonoscopy bowel preparation selection and pre-colonoscopy follow-up care. This study aimed to better understand coordination of care between PCPs and gastroenterologists as well as the current availability of "open-access" screening colonoscopy. METHODS: A multiple-choice survey was developed to assess PCPs' experiences with open-access colonoscopy, their involvement in the pre-colonoscopy process, and follow-up after colonoscopy...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737118/subjective-cognitive-decline-is-longitudinally-associated-with-lower-health-related-quality-of-life
#6
Susanne Roehr, Tobias Luck, Alexander Pabst, Horst Bickel, Hans-Helmut König, Dagmar Lühmann, Angela Fuchs, Steffen Wolfsgruber, Birgitt Wiese, Siegfried Weyerer, Edelgard Mösch, Christian Brettschneider, Tina Mallon, Michael Pentzek, Michael Wagner, Silke Mamone, Jochen Werle, Martin Scherer, Wolfgang Maier, Frank Jessen, Steffi G Riedel-Heller
BACKGROUND: Subjective cognitive decline (SCD), the potentially earliest notable manifestation of preclinical Alzheimer's disease and other dementias, was consistently associated with lower quality of life in cross-sectional studies. The aim of this study was to investigate whether such an association persists longitudinally - particularly with health-related quality of life (HRQoL) in older individuals without cognitive impairment. METHODS: Data were derived from follow-up 2-6 of the prospective Germany Study on Ageing, Cognition and Dementia in Primary Care (AgeCoDe) covering a total six-year observation period...
July 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28737026/misconceptions-of-spanish-general-practitioners-attitudes-toward-the-management-of-urinary-tract-infections-and-asymptomatic-bacteriuria-an-internet-based-questionnaire-study
#7
C Llor, A Moragas, S Hernández, S Crispi, J M Cots
OBJECTIVE: The diagnosis and management of urinary tract infections (UTI) vary widely across countries and practices. The objective of this study was to gain insight into general practitioners' (GP) perceptions on the current management of UTIs and asymptomatic bacteriuria in Spain. METHODS: Cross-sectional, internet-based questionnaire study answered from July to September 2013. GPs affiliated with the largest Spanish scientific society in primary care (Sociedad Española de Medicina Familiar y Comunitaria) were invited to participate in the study...
July 24, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28736934/using-social-media-to-engage-nurses-in-health-policy-development
#8
Siobhan O'Connor
AIMS: To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. BACKGROUND: Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. METHODS: A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software...
July 23, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28736913/a-community-responsive-adaptation-to-reach-and-engage-latino-families-affected-by-maternal-depression
#9
Carmen R Valdez, Alyssa Ramirez Stege, Elizabeth Martinez, Stephanie D'Costa, Thomas Chavez
As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community...
July 23, 2017: Family Process
https://www.readbyqxmd.com/read/28736726/social-and-emotional-wellbeing-screening-for-aboriginal-and-torres-strait-islanders-within-primary-health-care-a-series-of-missed-opportunities
#10
Erika Langham, Janya McCalman, Veronica Matthews, Roxanne Gwendalyn Bainbridge, Barbara Nattabi, Irina Kinchin, Ross Bailie
BACKGROUND: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS. METHODS: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28736725/intraoperative-radiation-therapy-a-promising-treatment-modality-in-head-and-neck-cancer
#11
REVIEW
Lara Hilal, Karine A Al Feghali, Paul Ramia, Ibrahim Abu Gheida, Jean-Pierre Obeid, Wassim Jalbout, Bassem Youssef, Fady Geara, Youssef H Zeidan
Every year, almost 62,000 are diagnosed with a head and neck cancer (HNC) and 13,000 will succumb to their disease. In the primary setting, intraoperative radiation therapy (IORT) can be used as a boost in select patients in order to optimize local control. Addition of external beam radiation to limited volumes results in improved disease control over surgery and IORT alone. In the recurrent setting, IORT can improve outcomes from salvage surgery especially in patients previously treated with external beam radiation...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#12
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736211/applying-contemporary-neuroscience-in-exercise-interventions-for-chronic-spinal-pain-treatment-protocol
#13
Malfliet Anneleen, Kregel Jeroen, Meeus Mira, Cagnie Barbara, Roussel Nathalie, Dolphens Mieke, Danneels Lieven, Nijs Jo
BACKGROUND: Nonspecific chronic spinal pain is a common problem within the chronic pain population and is characterized by high social, economic and personal impact. To date, therapists are still struggling in adequately treating these types of patients, as seen in the small and short-term benefits of frequently applied primary care treatments. It is remarkable that despite the well-documented presence of abnormalities in central nociceptive processing in nonspecific chronic spinal pain patients, the implementation of this knowledge in clinical practice is still nearly non-existent...
July 8, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28736032/central-line-associated-bloodstream-infection-rate-elevation-attributable-to-national-healthcare-safety-network-surveillance-definition-changes-ongoing-opportunities-for-infection-prevention-or-both
#14
Andrew Corley, Maggie Cantara, Julia Gardner, Polly Trexler, Clare Rock, Lisa L Maragakis
Calendar year 2015 intensive care unit (ICU) central line-associated bloodstream infections (CLABSIs) from 1 hospital were reviewed using 2014 CLABSI surveillance definitions to assess the relative impact of definition changes and infection control practices on CLABSI rates. Increased ICU primary CLABSI rates were found to be a result of both surveillance definition changes and infection control practices.
July 20, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28735500/adherence-to-copd-management-guidelines-in-general-practice-a-review-of-the-literature
#15
REVIEW
J Sehl, J O'Doherty, R O'Connor, B O'Sullivan, A O'Regan
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive illness that is mostly managed in the general practice setting. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are the international gold standard, and it is important to understand how these are being applied in general practice. AIMS: This review aimed to assess the current level of adherence to international best practice guidelines among general practitioners in relation to COPD...
July 22, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28735276/mental-health-literacy-in-primary-care-canadian-research-and-education-for-the-advancement-of-child-health-canreach
#16
Eden S N McCaffrey, Samuel Chang, Geraldine Farrelly, Abdul Rahman, David Cawthorpe
The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period...
July 22, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28735271/a-collaborative-approach-to-facilitate-professionals-to-support-the-breathless-patient
#17
Vanessa Shaw, Alison Davies, Bie Nio Ong
OBJECTIVES: Breathlessness is a major problem for people in their last weeks of life. Breathlessness is considered to be multidimensional with physical, psychological, emotional, social and spiritual factors all playing a part. It has been recognised that specific training to health professionals is beneficial in order to improve the care for patients with breathlessness.Breathlessness courses have tended to focus on senior nurses. A new flexible and collaborative training course was designed to include a wider range of nurses and other health professionals in hospital, hospice, primary care and community settings...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28734557/-conversational-advice-a-mixed-methods-analysis-of-medical-residents-experiences-co-managing-primary-care-patients-with-behavioral-health-providers
#18
Patrick Hemming, R B Levine, Joseph J Gallo
OBJECTIVE: When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents' behavioral health (BH) management learning. METHODS: Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned. Qualitative responses were coded thematically using a constant comparative method...
July 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28733799/a-toddler-parenting-intervention-in-primary-care-for-caregivers-with-depression-symptoms
#19
Rhonda C Boyd, Marsha Gerdes, Brooke Rothman, Susan L Dougherty, Russell Localio, James P Guevara
Caregiver depression impacts parenting behaviors and has deleterious effects on child behavior. Evidence-based interventions to address parenting have not been adapted for use with depressed caregivers in pediatric primary care settings. Our study examined the feasibility and explored outcomes of an evidence-based parenting program implemented in primary care and adapted for caregivers with depressive symptoms caring for toddlers. We conducted a randomized controlled trial with a wait-list control. Participants were caregivers who screened positive for depressive symptoms in pediatric settings with a toddler...
July 21, 2017: Journal of Primary Prevention
https://www.readbyqxmd.com/read/28733300/exploring-the-relationship-between-frequent-internet-use-and-health-and-social-care-resource-use-in-a-community-based-cohort-of-older-adults-an-observational-study-in-primary-care
#20
Caroline S Clarke, Jeff Round, Stephen Morris, Kalpa Kharicha, John Ford, Jill Manthorpe, Steve Iliffe, Claire Goodman, Kate Walters
OBJECTIVES: Given many countries' ageing populations, policymakers must consider how to mitigate or reduce health problems associated with old age, within budgetary constraints. Evidence of use of digital technology in delaying the onset of illness and reducing healthcare service use is mixed, with no clear consensus as yet. Our aim was to investigate the relationship between frequent internet use and patterns of health or social care resource use in primary care attendees who took part in a study seeking to improve the health of older adults...
July 21, 2017: BMJ Open
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