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https://www.readbyqxmd.com/read/29150885/recognizing-the-haystack-is-the-task-of-the-primary-care-physician
#1
N A Kukutsch, G Argenziano, W Bergman
In a reply to our letter Ferrandiz and colleagues wondered why dermoscopy experts did not already fully embrace teledermoscopy (TD) for suspicious pigmented skin lesions.(1) Our study showed that the structure of the health systems that were investigated differed, with countries where primary care physicians (PCP) hold a gate keeper function and others with direct access to a dermatologist. Significant differences in waiting time and travel distance were observed.(2) Since we believe that there is enough evidence that the addition of high quality dermoscopic pictures to a teleconsultation leads to higher accuracy of the diagnosis we did not investigate this question in our survey...
November 17, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29148198/ear-nose-and-throat-surgery-all-you-need-to-know-about-the-surgical-approach-to-the-management-of-middle-ear-effusions-in-australian-indigenous-and-non-indigenous-children
#2
REVIEW
Kelvin Kong, Francis J Lannigan, Peter S Morris, Amanda J Leach, Stephen J O'Leary
Otitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle-ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29135901/clinical-factors-associated-with-pediatric-brain-neoplasms-versus-primary-headache-a-case-control-analysis
#3
David C Sheridan, Bethany Waites, Bradley Lezak, Robert J Coryell, Kellie J Nazemi, Amber L Lin, Rongwei Fu, Matthew L Hansen
OBJECTIVE: Pediatric headaches are a common presentation to emergency departments accounting for almost half a million annual visits. Providers are left with the difficult task of deciding who has a secondary headache etiology that warrants neuroimaging. METHODS: We conducted a retrospective case-control study. Patients from a pediatric neuro-oncology clinic database with brain cancer and a headache at presentation were identified as cases. Controls were patients from 2 local pediatric tertiary care emergency departments with a final diagnosis of headache after negative neuroimaging...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29133489/continuity-of-primary-care-and-emergency-hospital-admissions-among-older-patients-in-england
#4
Peter Tammes, Sarah Purdy, Chris Salisbury, Fiona MacKichan, Daniel Lasserson, Richard W Morris
PURPOSE: Secondary health care services have been under considerable pressure in England as attendance rates increase, resulting in longer waiting times and greater demands on staff. This study's aim was to examine the association between continuity of care and risk of emergency hospital admission among older adults. METHODS: We analyzed records from 10,000 patients aged 65 years and older in 2012 within 297 English general practices obtained from the Clinical Practice Research Datalink and linked with Hospital Episode Statistics...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29132445/physician-remuneration-for-remote-consults-an-overview-of-approaches-across-canada
#5
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29131328/headache-education-active-waiting-directive-a-program-to-enhance-well-being-during-long-referral-wait-times
#6
Ana Marissa Lagman-Bartolome, Valerie Lawler, Christine Lay
OBJECTIVE: The aim of this initiative was to evaluate the clinical impact, patient acceptability, and sustainability of implementing a newly developed evidence-guided migraine education program in an academic headache center. BACKGROUND: Headache is the fifth most common reason for emergency department (ED) visits and accounts for more than 10 million physician visits annually. Successful management of headaches presents a challenge to both primary care providers and neurologists...
November 12, 2017: Headache
https://www.readbyqxmd.com/read/29127076/tailored-web-based-interventions-for-pain-systematic-review-and-meta-analysis
#7
Geraldine Martorella, Madalina Boitor, Melanie Berube, Suzanne Fredericks, Sylvie Le May, Céline Gélinas
BACKGROUND: Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated...
November 10, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29105879/efficacy-of-a-web-based-intervention-with-and-without-guidance-for-employees-with-risky-drinking-results-of-a-three-arm-randomized-controlled-trial
#8
Leif Boß, Dirk Lehr, Michael Patrick Schaub, Raquel Paz Castro, Heleen Riper, Matthias Berking, David Daniel Ebert
AIMS: To test the efficacy of a web-based alcohol intervention with and without guidance. DESIGN: Three parallel groups with primary endpoint after 6 weeks. SETTING: Open recruitment in the German working population. PARTICIPANTS: Adults (178 males/ 256 females, mean age of 47) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥8/6 on the Alcohol Use Disorders Identification Test. INTERVENTION: Five web-based modules including personalized normative feedback, motivational interviewing, goal setting, problem solving, and emotion regulation over 5 weeks...
November 4, 2017: Addiction
https://www.readbyqxmd.com/read/29097298/study-design-and-methods-for-the-activity-and-technology-activate-trial
#9
Brigid M Lynch, Nga H Nguyen, Marina M Reeves, Melissa M Moore, Dori E Rosenberg, Michael J Wheeler, Terry Boyle, Jeff K Vallance, Christine M Friedenreich, Dallas R English
BACKGROUND: Physical activity is positively associated with survival and quality of life among breast cancer survivors. Despite these benefits, the majority of breast cancer survivors are insufficiently active. The potential health benefits of reducing sedentary behaviour (sitting time) in this population have not been extensively investigated. The ACTIVATE Trial will evaluate the efficacy of an intervention that combines wearable technology (the Garmin Vivofit2®) with traditional behavioural change approaches to increase physical activity and reduce sedentary behaviour performed by breast cancer survivors...
October 30, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29094806/performance-of-an-algorithm-based-approach-to-the-diagnosis-and-management-of-functional-gastrointestinal-disorders-a-pilot-trial
#10
E C Linedale, A Mikocka-Walus, A D Vincent, P R Gibson, J M Andrews
BACKGROUND: Recent advances in the development of diagnostic criteria and effective management options for functional gastrointestinal disorders (FGIDs) have not yet been integrated into clinical practice. There is a clear need for the development and validation of a simple clinical pathway for the diagnosis and management of FGIDs which can be used in primary care. METHODS: In this controlled pilot study, we designed and evaluated a non-specialist-dependent, algorithm-based approach for the diagnosis and management of FGIDs (ADAM-FGID)...
November 2, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29082858/an-internet-based-intervention-for-chronic-pain
#11
Jiaxi Lin, Sarah Paganini, Lasse Sander, Marianne Lüking, David Daniel Ebert, Monica Buhrman, Gerhard Andersson, Harald Baumeister
BACKGROUND: Persons with chronic pain can be treated effectively with acceptance and commitment therapy (ACT). In this trial, we examined the effectiveness of guided and unguided ACT-based online treatment (ACTonPain) for chronic pain patients. METHODS: 302 individuals were randomly assigned to ACTonPain with or without guidance (n = 100/101) or to a waiting-list control group (n=101). The primary outcome was pain interference as measured by the Multidimensional Pain Inventory...
October 13, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29077669/quality-and-variability-of-cardiovascular-rehabilitation-delivery-applying-the-canadian-quality-indicators
#12
Deborah S Somanader, Caroline Chessex, Liane Ginsburg, Sherry L Grace
PURPOSE: Cardiac care, including cardiovascular rehabilitation (CR), is most effective if it is high-quality. The aim of this study was to describe CR quality, using the recently developed Canadian Cardiovascular Society CR quality indicators (QIs). Difference in quality between CR sites was also assessed. METHODS: Secondary analysis was conducted on an observational, prospective, multisite CR program evaluation cohort. A convenience sample of patients from 1 of 3 CR programs was approached at their first CR visit, and consenting participants completed a survey...
November 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29073339/autism-and-primary-care-dentistry-parents-experiences-of-taking-children-with-autism-or-working-diagnosis-of-autism-for-dental-examinations
#13
Nicole Thomas, Sharon Blake, Christopher Morris, David R Moles
BACKGROUND: Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. AIM: To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. DESIGN: A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews...
October 26, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/29072931/effectiveness-and-cost-effectiveness-of-tuina-for-chronic-neck-pain-a-randomized-controlled-trial-comparing-tuina-with-a-no-intervention-waiting-list
#14
Daniel Pach, Mike Piper, Fabian Lotz, Thomas Reinhold, Mirja Dombrowski, Yinghui Chang, Bin Liu, Susanne Blödt, Gabriele Rotter, Katja Icke, Claudia M Witt
OBJECTIVE: To evaluate whether tuina is more effective and cost-effective in reducing pain compared to no intervention in patients with chronic neck pain. DESIGN: Single-center randomized two-armed controlled trial. SETTING: University outpatient clinic specialized in Integrative Medicine. SUBJECTS: Outpatients with chronic neck pain were randomly allocated to tuina or no intervention. INTERVENTION: Six tuina treatments within 3 weeks...
October 26, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29070050/potential-barriers-in-healthcare-access-of-the-elderly-population-influenced-by-the-economic-crisis-and-the-troika-agreement-a-qualitative-case-study-in-lisbon-portugal
#15
Julia Doetsch, Eva Pilot, Paula Santana, Thomas Krafft
BACKGROUND: The recent economic and financial crisis in Portugal urged the Portuguese Government in April 2011 to request financial assistance from the troika austerity bail out program to get aid for its government debt. The troika agreement included health reforms and austerity measures of the National Health Service (NHS) in Portugal to save non-essential health care costs. This research aimed to identify potential barriers among the elderly population (aged 65 and above) to healthcare access influenced by the economic crisis and the troika agreement focussing on the Memorandum of Understanding on Specific Economic Policy Conditionality (MoU) in Lisbon metropolitan area, Portugal...
October 25, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29067156/the-national-oesophagogastric-cancer-awareness-campaign-a-locality-outcome-analysis-from-county-durham
#16
Sara Koo, Bidour Awadelkarim, Anjan Dhar
INTRODUCTION: Oesophageal and gastric cancer is common. Despite advances in investigation and treatment, the outcomes from these cancers remain poor. As part of the Be Clear On Cancer Campaign, the Department of Health runs the National Oesophagogastric Cancer Campaign each year, with key messages of (1) 'Having heartburn most days, for 3 weeks or more could be a sign of cancer' and (2) 'if food is sticking when you swallow, tell your doctor'. METHODS: We evaluated the effect of the National Oesophagogastric Cancer Campaign in our locality...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29061478/impact-of-dermatology-econsults-on-access-to-care-and-skin-cancer-screening-in-underserved-populations-a-model-for-teledermatology-services-in-community-health-centers
#17
Fludiona Naka, Jun Lu, Anthony Porto, Jose Villagra, Zhao Helen Wu, Daren Anderson
BACKGROUND: The clinical outcome of teledermatology with dermoscopy in large-scale primary care networks remains unclear. OBJECTIVE: We evaluate the impact of implementing a teledermatology consultation program with dermoscopy on a statewide scale, focusing on access to care and skin cancer screening for medically underserved populations. METHODS: Descriptive retrospective cohort study of 2385 dermatology referrals from primary care from June 2014 through November 2015...
October 20, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29052345/views-of-diverse-primary-care-patients-on-the-roles-of-healthcare-providers-and-staff-and-the-influence-of-other-variables-in-their-weight-management
#18
C M Tucker, J L Williams, G M Wippold, L A Bilello, T A Morrissette, A J Good, N R Shah, N E Rowland
The prevalence of overweight/obesity is disproportionately higher among racial/ethnic minority and low-income patients. The purpose of this study was to survey racially diverse, low-income patients regarding their experiences with and desires regarding their providers' involvement in weight management. Adult patients (N = 529), including mostly African American (42.7%), White (44.6%) and low-income (55.5% with incomes <$30 000) patients from 7 Patient-Centered Medical Homes voluntarily completed a brief anonymous survey while waiting to see their providers...
October 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/29043279/the-effect-of-emotional-focused-intervention-on-spousal-emotional-abuse-and-marital-satisfaction-among-elderly-married-couples-a-randomized-controlled-trial
#19
Maryam Hazrati, Tengku Aizan Hamid, Rahimah Ibrahim, Siti Aishah Hassan, Farkhondeh Sharif, Zahra Bagheri
BACKGROUND: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples. METHODS: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers...
October 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/29042808/first-visit-patients-without-a-referral-to-the-department-of-internal-medicine-at-a-medium-sized-acute-care-hospital-in-japan-an-observational-study
#20
Nobuyuki Kajiwara, Kazuyuki Hayashi, Masahiro Misago, Shinichiro Murakami, Takato Ueoka
PURPOSE: We sought to profile first-time patients without a referral who sought medical care at the Department of Internal Medicine at a medium-sized acute care hospital in Japan. We anticipated that the analysis would highlight the demand for medical care needs from acute care hospitals and help confirm one of the problems associated with primary care in Japan. PATIENTS AND METHODS: The study population comprised 765 patients who sought outpatient consultation without a referral at "the Department of General Internal Medicine" at the Ikeda City Hospital on Fridays over 4 years...
2017: International Journal of General Medicine
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