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https://www.readbyqxmd.com/read/28086953/student-and-faculty-perceptions-on-the-rapid-scale-up-of-medical-students-in-ethiopia
#1
Brittney S Mengistu, Holly Vins, Caitrin M Kelly, Daphne R McGee, Jennifer O Spicer, Miliard Derbew, Abebe Bekele, Damen Haile Mariam, Carlos Del Rio, Henry M Blumberg, Dawn L Comeau
BACKGROUND: Ethiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Recently, the Ethiopian government implemented a "flood and retain" initiative to rapidly increase the quantity of physicians in Ethiopia. Consequently, medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300-400 students per class. This study evaluated the impact of the rapid scale-up in the number of medical students on the quality of medical education at AAU and the impact of the U...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28086866/perceptions-and-utilization-of-generic-medicines-in-guatemala-a-mixed-methods-study-with-physicians-and-pharmacy-staff
#2
David Flood, Irène Mathieu, Anita Chary, Pablo García, Peter Rohloff
BACKGROUND: Access to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala is an LMIC where there is both limited availability and affordability of these medications. However, attitudes of physicians and pharmacy staff regarding low-cost generics, especially generics for non-communicable diseases (NCDs), have not been fully explored in Guatemala. METHODS: Semi-structured interviews with 30 pharmacy staff and 12 physicians in several highland towns in Guatemala were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086837/systemic-and-individual-factors-in-the-buprenorphine-treatment-seeking-process-a-qualitative-study
#3
Valerie M Hewell, Angel R Vasquez, Inna D Rivkin
BACKGROUND: Opioid use is a significant problem in Alaska. Medication-assisted treatment for opioid use, including buprenorphine, reduces withdrawal symptoms and the harm associated with opioid abuse. Understanding consumers' treatment-seeking process is important for addressing barriers to treatment, facilitating effective service utilization, and informing policy. METHODS: To understand treatment-seeking behavior, we examined the attitudes, perceptions, and knowledge of those who would benefit from the medication-assisted treatment (MAT) buprenorphine...
January 11, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28086813/information-exchange-networks-of-health-care-providers-and-evidence-based-cardiovascular-risk-management-an-observational-study
#4
Naomi Heijmans, Jan van Lieshout, Michel Wensing
BACKGROUND: Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM. METHODS: This observational study was performed parallel to a randomized clinical trial which aimed to improve professional performance of practice nurses in the Netherlands...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28086792/irish-general-practitioner-attitudes-toward-decriminalisation-and-medical-use-of-cannabis-results-from-a-national-survey
#5
Des Crowley, Claire Collins, Ide Delargy, Eamon Laird, Marie Claire Van Hout
BACKGROUND: Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). METHODS: General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey...
January 13, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28086762/prevalence-and-risk-factors-of-congenital-heart-defects-among-live-births-a-population-based-cross-sectional-survey-in-shaanxi-province-northwestern-china
#6
Leilei Pei, Yijun Kang, Yaling Zhao, Hong Yan
BACKGROUND: Nearly half of the population of Northwest China live in Shaanxi province, but population-based data on the epidemiologic characteristics of congenital heart defects (CHD) in this population is limited. The study aimed to investigate the prevalence and epidemiologic characteristics of the CHD among infants born between 2010 and 2013 in Shaanxi province. METHODS: Infants born between 2010 and 2013 in Shaanxi province were surveyed using a stratified multi-stage sampling method...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28079809/a-comparison-of-the-surgical-mortality-due-to-colorectal-perforation-at-different-hospitals-with-data-from-10-090-cases-in-the-japanese-national-clinical-database
#7
Takeshi Ohki, Masakazu Yamamoto, Hiroaki Miyata, Yasuto Sato, Yoshihisa Saida, Tsuyoshi Morimoto, Hiroyuki Konno, Yasuyuki Seto, Koichi Hirata
Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28077828/-hospital-arrival-rate-within-golden-time-and-factors-influencing-prehospital-delays-among-patients-with-acute-myocardial-infarction
#8
Hye Mi Ahn, Hyeongsu Kim, Kun Sei Lee, Jung Hyun Lee, Hyo Seon Jeong, Soung Hoon Chang, Kyeong Ryong Lee, Sung Hea Kim, Eun Young Shin
PURPOSE: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). METHODS: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction...
December 2016: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#9
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28077228/levers-for-addressing-medical-underuse-and-overuse-achieving-high-value-health-care
#10
REVIEW
Adam G Elshaug, Meredith B Rosenthal, John N Lavis, Shannon Brownlee, Harald Schmidt, Somil Nagpal, Peter Littlejohns, Divya Srivastava, Sean Tunis, Vikas Saini
The preceding papers in this Series have outlined how underuse and overuse of health-care services occur within a complex system of health-care production, with a multiplicity of causes. Because poor care is ubiquitous and has considerable consequences for the health and wellbeing of billions of people around the world, remedying this problem is a morally and politically urgent task. Universal health coverage is a key step towards achieving the right care. Therefore, full consideration of potential levers of change must include an upstream perspective-ie, an understanding of the system-level factors that drive overuse and underuse, as well as the various incentives at work during a clinical encounter...
January 6, 2017: Lancet
https://www.readbyqxmd.com/read/28077109/cause-of-neonatal-deaths-in-northern-ethiopia-a-prospective-cohort-study
#11
Hayelom Gebrekirstos Mengesha, Berhe W Sahle
BACKGROUND: Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia. METHODS: A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia...
January 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28077072/diabetes-mellitus-medication-use-and-catastrophic-healthcare-expenditure-among-adults-aged-50-years-in-china-and-india-results-from-the-who-study-on-global-ageing-and-adult-health-sage
#12
Shingai Douglas Gwatidzo, Jennifer Stewart Williams
BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India...
January 11, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28076644/main-mental-disorders-in-crack-cocaine-users-treated-at-psychosocial-care-centers-for-alcohol-and-drugs-in-the-city-of-recife-brazil
#13
Antonio Gomes de Castro, Diego César Nunes da Silva, Magda da Silva Figueiroa
Introduction: Brazil's Northeast region has the highest crack-cocaine consumption in the country. Crack-cocaine has more intense effects than cocaine powder and can cause greater chemical dependence. Psychosocial Care Centers for Alcohol and Drugs (CAPSad) are public health services that provide treatment for drug dependence. It is common for drug users, and particularly crack-cocaine users, to develop mental disorders. Objective: To evaluate the most common mental disorders in crack-cocaine dependents in treatment at CAPSad in the city of Recife, Brazil...
October 2016: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28076586/predictors-of-readiness-for-oral-rapid-hiv-testing-by-chilean-health-care-providers
#14
Lisette P Irarrázabal, Judith A Levy, Kathleen F Norr, Rosina Cianelli, L Michele Issel, Carlos M Pérez, Anna Hotton
Objective: This study identified the personal characteristics that affect Chilean health care providers' readiness to adopt HIV Oral Rapid Testing (ORT) in Chile as a new clinical evidence-based practice (EBP). Methods: Using a cross-sectional research design, the study sampled 150 nurses, midwives, and physicians employed at four clinics within the Pontifícia Universidad Católica de Chile Health Network in Santiago. Participants completed a self-administered survey asking about their demographic background, EBP attitudes and experience, personal beliefs related to HIV, the importance of HIV testing, and perceived self-comfort in performing a rapid HIV test...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28075699/outcome-and-impact-evaluation-of-a-transgender-health-course-for-health-profession-students
#15
Hannan M Braun, Ilana R Garcia-Grossman, Andrea Quiñones-Rivera, Madeline B Deutsch
PURPOSE: Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge...
January 11, 2017: LGBT Health
https://www.readbyqxmd.com/read/28075696/dual-eligibles-experience-of-care-with-north-carolina-s-patient-centered-medical-home
#16
Sarah Grantham, Debora Goetz Goldberg, Donna Lind Infeld
Although individuals enrolled in both Medicare and Medicaid (dual eligibles) are among those with the nation's greatest need, at $300 billion per year, their care is also expensive and beset by quality problems. Previous research found problems associated with inadequate coordination of benefits and services; however, these studies have largely used quantitative approaches and focused on providers-few studies have explored the perspective of dual eligible patients. In an effort to improve care and reduce costs, North Carolina (NC) developed a Patient-Centered Medical Home (PCMH) model centered on a continuous relationship with a primary care provider who is responsible for coordination of services and addressing patients' health care needs by providing direct services or arranging care with other qualified professionals...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28075529/diabetes-hypertension-obesity-and-long-term-risk-of-renal-disease-mortality-racial-and-socioeconomic-differences
#17
Maryam Moghani Lankarani, Shervin Assari
INTRODUCTION: Diabetes, hypertension, and obesity increase risk of chronic kidney disease and associated mortality. Race and SES differences in the effects of these risk factors are, however, still unknown. Current study aimed to investigate whether or not race and SES alter the effects of diabetes, hypertension, and obesity on mortality due to renal diseases. MATERIALS AND METHODS: Data came from the Americans' Changing Lives Study (ACL), 1986 to 2011, a nationally representative prospective cohort of adults with 25 years of follow up...
January 11, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28074727/-flank-pain-caused-by-a-renal-artery-dissection
#18
J C Karper, W M T Janssen, J C Breek, R Oosterhof-Berktas, J Gravendeel, T K Kremer Hovinga
BACKGROUND: A spontaneous renal artery dissection is a very rare diagnosis. The clinical presentation can vary and its course can be atypical. There are no guidelines available regarding treatment; however, the options are a conservative (medication) or interventional (radiological or surgical) approach. CASE DESCRIPTION: A 45-year-old man presented to the emergency department with hypertensive urgency after earlier episodes of flank pain. The cause appeared to be a spontaneous bilateral renal artery dissection with infarction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28074589/on-patient-well-being-and-professional-authority
#19
Mildred Z Solomon
Two papers in this issue address the limits of surrogates' authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and every effort made to work with surrogates as harmoniously as possible...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074587/after-the-dnr-surrogates-who-persist-in-requesting-cardiopulmonary-resuscitation
#20
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
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