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https://www.readbyqxmd.com/read/28209049/5-point-checklist-for-skin-cancer-detection-in-primary-care
#1
Elvira Moscarella, Aimilios Lallas, Caterina Longo, Roberto Alfano, Giuseppe Argenziano
BACKGROUND: Skin cancer screening interventions often relay on the involvement of general practitioners (GPs). Many interventions up to now have been directed to training approaches focusing on the clinical features of skin malignancies to increase GPs skill in skin cancer recognition. METHODS: Based on the available current knowledge about skin cancer epidemiology and risk factors, we built up a 5-point checklist to help GPs in triaging patients to be referred to a dermatologist...
February 16, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28173782/healthesteps%C3%A2-study-protocol-a-pragmatic-randomized-controlled-trial-promoting-active-living-and-healthy-lifestyles-in-at-risk-canadian-adults-delivered-in-primary-care-and-community-based-clinics
#2
Dawn P Gill, Wendy Blunt, Cassandra Bartol, Roseanne W Pulford, Ashleigh De Cruz, P Karen Simmavong, Adam Gavarkovs, Ian Newhouse, Erin Pearson, Bayley Ostenfeldt, Barbi Law, Kristina Karvinen, Pertice Moffit, Gareth Jones, Cori Watson, Guangyong Zou, Robert J Petrella
BACKGROUND: Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits...
February 7, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28169817/%C3%A3-valuation-d%C3%A2-un-nouvel-outil-d%C3%A2-information-dans-un-service-d%C3%A2-urgence
#3
Anne Pouessel, Anthony Chauvin, Jennifer Truchot, Matthieu Resche-Rigon, Bertrand Galichon, Patrick Plaisance
<ce:para>Aims : emergency Departments represent unique and complex entities that must be understood by the public. Objectives : to increase, by setting up screens, the number of information integrated by the patients during their waiting before medical care.</ce:para><ce:para>Method : Cohort, before/after implementation of information screens, prospective, evaluative, monocentric study. Patients were interviewed on the location of the hospital, the organization of the Emergency Department, their legal rights...
October 27, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28167747/integrated-collaborative-care-teams-to-enhance-service-delivery-to-youth-with-mental-health-and-substance-use-challenges-protocol-for-a-pragmatic-randomised-controlled-trial
#4
Joanna L Henderson, Amy Cheung, Kristin Cleverley, Gloria Chaim, Myla E Moretti, Claire de Oliveira, Lisa D Hawke, Andrew R Willan, David O'Brien, Olivia Heffernan, Tyson Herzog, Lynn Courey, Heather McDonald, Enid Grant, Peter Szatmari
INTRODUCTION: Among youth, the prevalence of mental health and addiction (MHA) disorders is roughly 20%, yet youth are challenged to access evidence-based services in a timely fashion. To address MHA system gaps, this study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges. A rapid, stepped-care approach geared to need in a youth-friendly environment is expected to result in better youth MHA outcomes. Moreover, the ICCT approach is expected to decrease service wait-times, be more youth-friendly and family-friendly, and be more cost-effective, providing substantial public health benefits...
February 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28152927/reducing-wait-time-wt-in-the-infusion-center-ic
#5
Lianne Lopez, Angela Aschian, Betty Chan, Martha Inofuentes, Zoraida Truax, Sally Golingay, Gwendoyn Lynch, Peggy Matsuura, Afsaneh Barzi
: 249 Background: Lengthy WT is the primary source of dis-satisfaction with IC services. We created a patient (PT) flow diagram outlining each step beginning from PT check-in to discharge and plotted the impact of multiple disciplines on the WT. A team of nurses, pharmacists, physicians, and administrators, analyzed the flow and identified ways to improve efficiencies. METHODS: First attempt was to improve communications between pharmacy and nursing, coordinating the preparation of medications with patient's check-in time; use of a simple clipboard facilitated this task and improved the efficiency of the system...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#6
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28139461/slovakia-health-system-review
#7
Martin Smatana, Peter Pazitny, Daniela Kandilaki, Michaela Laktisova, Darina Sedlakova, Monika Paluskova, Ewout van Ginneken, Anne Spranger
This analysis of the Slovak health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The health care system in Slovakia is based on universal coverage, compulsory health insurance, a basic benefit package and a competitive insurance model with selective contracting of health care providers. Containment of health spending became a major policy goal after the 2008 financial crisis. Health spending stabilized after 2010 but remains well below European averages...
November 2016: Health Systems in Transition
https://www.readbyqxmd.com/read/28135690/wasting-the-doctor-s-time-a-video-elicitation-interview-study-with-patients-in-primary-care
#8
Nadia Llanwarne, Jennifer Newbould, Jenni Burt, John L Campbell, Martin Roland
Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary...
January 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28130953/primary-care-collaborative-memory-clinics-building-capacity-for-optimized-dementia-care
#9
Linda Lee, Loretta M Hillier, Frank Molnar, Michael J Borrie
Increasingly, primary care collaborative memory clinics (PCCMCs) are being established to build capacity for person-centred dementia care. This paper reflects on the significance of PCCMCs within the system of care for older adults, supported with data from ongoing evaluation studies. Results highlight timelier access to assessment with a high proportion of patients being managed in primary care within a person-centred approach to care. Enhancing primary care capacity for dementia care with interprofessional and collaborative care will strengthen the system's ability to respond to increasing demands for service and mitigate the growth of wait times to access geriatric specialist assessment...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28129783/the-self-help-online-against-suicidal-thoughts-sos-trial-study-protocol-for-a-randomized-controlled-trial
#10
Charlotte Mühlmann, Trine Madsen, Carsten Hjorthøj, Ad Kerkhof, Merete Nordentoft, Annette Erlangsen
BACKGROUND: Suicidal thoughts are common, causing distress for millions of people all over the world. However, people with suicidal thoughts might not access support due to financial restraints, stigma or a lack of available treatment offers. Self-help programs provided online could overcome these barriers, and previous efforts show promising results in terms of reducing suicidal thoughts. This study aims to examine the effectiveness of an online self-help intervention in reducing suicidal thoughts among people at risk of suicide...
January 28, 2017: Trials
https://www.readbyqxmd.com/read/28127716/single-hospital-visit-elective-day-case-laparoscopic-cholecystectomy-without-prior-outpatient-attendance
#11
N J Curtis, P D Robinson, N J Carty
INTRODUCTION: Eighty percent of all UK elective laparoscopic cholecystectomies (LC) are performed as day-case procedures, but the pre-operative patient pathway has received little attention. In response to local patient feedback, we aimed to introduce a single hospital visit pathway for day-case LC. METHODS: A single hospital visit pathway for elective LC was piloted alongside standard services. Following telephone consultation, a pack containing procedure information, knowledge questionnaire and consent form were sent...
January 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28123955/why-test-for-tuberculosis-a-qualitative-study-from-south-africa
#12
D Skinner, M Claassens
Setting: Early testing and treatment initiation are crucial for controlling the tuberculosis (TB) epidemic, especially in high-burden countries such as South Africa. Objective: To explore reasons why patients opted to test for TB and the context in which they were tested. Design: This qualitative study was nested in a larger study evaluating patients who did not initiate anti-tuberculosis treatment after diagnosis. In-depth interviews were conducted with 41 patients across five provinces of South Africa. Results: While most patients presented for testing because of their symptoms, unfortunately many waited until their symptoms were severe and thus remained infectious for longer...
December 21, 2016: Public Health Action
https://www.readbyqxmd.com/read/28122845/health-reforms-in-china-the-public-s-choices-for-first-contact-care-in-urban-areas
#13
Dan Wu, Tai Pong Lam, Kwok Fai Lam, Xu Dong Zhou, Kai Sing Sun
PURPOSE: To examine the public's views towards their choice of first-contact care and its associated factors in urban China. METHODS: A mixed-method study was adopted using individual interviews, focus group interviews and a cross-sectional survey. The study was conducted among the general public between September 2014 and September 2015 in Zhejiang province, China. RESULTS: . Six focus groups and 13 individual interviews were conducted. The questionnaire was completed by 1248 respondents with a response rate of 83%...
January 24, 2017: Family Practice
https://www.readbyqxmd.com/read/28109279/a-comparative-analysis-of-centralized-waiting-lists-for-patients-without-a-primary-care-provider-implemented-in-six-canadian-provinces-study-protocol
#14
Mylaine Breton, Michael Green, Sara Kreindler, Jason Sutherland, Jalila Jbilou, Sabrina T Wong, Jay Shaw, Valorie A Crooks, Damien Contandriopoulos, Mélanie Ann Smithman, Astrid Brousselle
BACKGROUND: Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be a prerequisite for obtaining healthcare that is timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the healthcare system. Yet, 4.6 million Canadians, approximately 15% of Canada's population, are unattached; that is, they do not have a regular primary care provider. To address the critical need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists for unattached patients...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28105767/investigations-and-referral-for-suspected-cancer-in-primary-care-in-new-zealand-a-survey-linked-to-the-international-cancer-benchmarking-partnership
#15
H W Htun, J M Elwood, S J Ioannides, T Fishman, R Lawrenson
A national internet-based survey of New Zealand (NZ) primary care physicians (n = 192) used the survey instrument developed by the International Cancer Benchmarking Partnership (ICBP). Practitioners were recruited by a range of methods assisted by NZ general practice networks and contacts. Compared to 11 other ICBP jurisdictions, direct access to diagnostic tests was more limited and took more time than in most other areas; the average wait for a test to be done and reported was 3.0 weeks for X-rays and 8...
January 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28094051/competition-policy-for-health-care-provision-in-portugal
#16
Pedro Pita Barros
We review the role of competition among healthcare providers in Portugal, which has a public National Health Service (NHS) at the core of the health system. There is little competition among healthcare providers within the NHS. Competition among NHS primary care providers is hindered by excess demand (many residents in Portugal do not have a designated family doctor). Competition among NHS hospitals has been traditionally limited to cases of maximum guaranteed waiting time for surgery being exceeded. The Portuguese Competition Authority enforces competition law...
February 2017: Health Policy
https://www.readbyqxmd.com/read/28076261/-how-can-we-talk-about-patient-centered-care-without-patients-at-the-table-lessons-learned-from-patient-advisory-councils
#17
Anjana E Sharma, Rachel Willard-Grace, Andrew Willis, Olivia Zieve, Kate Dubé, Charla Parker, Michael B Potter
CONTEXT AND OBJECTIVE: Patient advisory councils (PACs) are a strategy for primary care clinics to engage patients in practice improvement. However, there is scant research on how PACs function. This study aimed to understand how PACs are organized and identify common challenges and perceived benefits of high-functioning PACs. SETTING AND POPULATION: Key informants identified 8 primary care clinics in California with high-functioning PACs. Leaders from each of the 8 clinics nominated 1 clinic staff member and 1 PAC patient member to be interviewed...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28076254/watchful-waiting-strategy-may-reduce-low-value-diagnostic-testing
#18
Larissa May, Peter Franks, Anthony Jerant, Joshua Fenton
BACKGROUND: PCPs need effective communication strategies to address patient requests for low-value testing while sustaining patient-provider partnerships. Watchful waiting - allowing a negotiated period of time to pass before making a firm testing decision - shows promise as a tool for addressing patient requests for low-value testing. METHODS: Observational analysis of data from a randomized controlled trial of a communication intervention designed to boost patient-centeredness and reduce low-value test ordering among 61 resident primary care physicians...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28068998/a-qualitative-study-on-african-immigrant-and-refugee-families-experiences-of-accessing-primary-health-care-services-in-manitoba-canada-it-s-not-easy
#19
Roberta Lynn Woodgate, David Shiyokha Busolo, Maryanne Crockett, Ruth Anne Dean, Miriam R Amaladas, Pierre J Plourde
BACKGROUND: Immigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families. METHODS: Eighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015...
January 9, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28067816/indoor-temperatures-in-patient-waiting-rooms-in-eight-rural-primary-health-care-centers-in-northern-south-africa-and-the-related-potential-risks-to-human-health-and-wellbeing
#20
Caradee Y Wright, Renée A Street, Nokulunga Cele, Zamantimande Kunene, Yusentha Balakrishna, Patricia N Albers, Angela Mathee
Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities...
January 6, 2017: International Journal of Environmental Research and Public Health
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