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https://www.readbyqxmd.com/read/28535332/interventions-for-treating-anxiety-after-stroke
#1
REVIEW
Peter Knapp, C Alexia Campbell Burton, John Holmes, Jenni Murray, David Gillespie, C Elizabeth Lightbody, Caroline L Watkins, Ho-Yan Y Chun, Sharon R Lewis
BACKGROUND: Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an update of the review first published in October 2011. OBJECTIVES: The primary objective was to assess the effectiveness of pharmaceutical, psychological, complementary, or alternative therapeutic interventions in treating stroke patients with anxiety disorders or symptoms...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#2
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28532439/efficacy-cost-utility-and-reach-of-an-ehealth-self-management-application-oncokompas-that-helps-cancer-survivors-to-obtain-optimal-supportive-care-study-protocol-for-a-randomised-controlled-trial
#3
Anja van der Hout, Cornelia F van Uden-Kraan, Birgit I Witte, Veerle M H Coupé, Femke Jansen, C René Leemans, Pim Cuijpers, Lonneke V van de Poll-Franse, Irma M Verdonck-de Leeuw
BACKGROUND: Cancer survivors have to deal with a wide range of physical symptoms, psychological, social and existential concerns, and lifestyle issues related to cancer and its treatment. Therefore, it is essential that they have access to optimal supportive care services. The eHealth self-management application Oncokompas was developed to support cancer survivors with where they need to turn to for advice and guidance, as well as to increase their knowledge on the availability of optimal support...
May 22, 2017: Trials
https://www.readbyqxmd.com/read/28527640/influences-on-patient-satisfaction-among-patients-who-use-emergency-departments-frequently-for-pain-related-complaints
#4
Patricia Newcomb, Marian Wilson, Ralph Baine, Terence McCarthy, Nicholas Penny, Caroline Nixon, Justin Orren
INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28522162/implementing-shared-decision-making-for-diabetes-care-across-country-settings-what-really-matters-to-people
#5
Michela Tinelli, Panagiotis Petrou, George Samoutis, Vivie Traynor, George Olympios, Alistair McGuire
CONTEXT: Growing evidence of improved clinical outcomes and patient/professional satisfaction supports shared-decision-making (SDM) services as an effective primary care interventions for diabetes. However, only a few countries have actually adopted them (e.g. England). In other European countries (e.g. Cyprus) there is awareness that patients play a crucial role in decision-making, and SDM services could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care...
May 10, 2017: Health Policy
https://www.readbyqxmd.com/read/28503269/an-assessment-of-patient-waiting-and-consultation-time-in-a-primary-healthcare-clinic
#6
B A Ahmad, K Khairatul, A Farnaza
Waiting is a common phenomenon in the doctor's waiting room. The purpose of this audit is to assess patient waiting time and doctor consultation time in a primary healthcare clinic and to formulate strategies for improvement. This audit was conducted at a primary care clinic for 4 weeks using the universal sampling method. All patients who attended the clinic during this period was included in the study except for those who required more time to be seen such as those who were critically ill, aggressive or those who came for repeat medication or procedures only without needing to see the doctor...
2017: Malaysian Family Physician
https://www.readbyqxmd.com/read/28493626/why-do-people-choose-emergency-and-urgent-care-services-a-rapid-review-utilizing-a-systematic-literature-search-and-narrative-synthesis
#7
Joanne E Coster, Janette K Turner, Daniel Bradbury, Anna Cantrell
OBJECTIVES: Rising demand for emergency and urgent care services are well documented, as are the consequences, for example, ED crowding, increased costs, pressure on services and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions and behavioural changes relating to how people choose to access health services. The aim of this systematic mapping review is to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487349/patient-centred-innovations-for-persons-with-multimorbidity-funded-evaluation-protocol
#8
Moira Stewart, Martin Fortin
BACKGROUND: The high prevalence of multimorbidity necessitates rethinking of the health care system. The overarching goal of the Patient-Centred Innovations for Persons with Multimorbidity program is to build on existing structures and find and evaluate patient-centred innovations relevant to multimorbidity. METHODS: We describe the protocol for a proposed multijurisdictional (Quebec and Ontario) concurrent triangulation mixed-methods study. In both provinces, a qualitative descriptive study will be used to explore innovations in patient-centred multimorbidity care...
May 9, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28486953/sustainability-in-health-care-by-allocating-resources-effectively-share-3-examining-how-resource-allocation-decisions-are-made-implemented-and-evaluated-in-a-local-healthcare-setting
#9
Claire Harris, Kelly Allen, Cara Waller, Vanessa Brooke
BACKGROUND: This is the third in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Leaders in a large Australian health service planned to establish an organisation-wide, systematic, integrated, evidence-based approach to disinvestment. In order to introduce new systems and processes for disinvestment into existing decision-making infrastructure, we aimed to understand where, how and by whom resource allocation decisions were made, implemented and evaluated...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28485716/the-former-yugoslav-republic-of-macedonia-health-system-review
#10
Neda Milevska Kostova, Snezhana Chichevalieva, Ninez A Ponce, Ewout van Ginneken, Juliane Winkelmann
This analysis of the health system of the former Yugoslav Republic of Macedonia reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The country has made important progress during its transition from a socialist system to a market-based system, particularly in reforming the organization, financing and delivery of health care and establishing a mix of private and public providers. Though total health care expenditure has risen in absolute terms in recent decades, it has consistently fallen as share of GDP, and high levels of private health expenditure remain...
May 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28483824/patients-preferences-for-gp-consultation-for-perceived-cancer-risk-in-primary-care-a-discrete-choice-experiment
#11
Katriina L Whitaker, Alex Ghanouni, Yin Zhou, Georgios Lyratzopoulos, Stephen Morris
BACKGROUND: Contacting a doctor for advice when experiencing a potential cancer symptom is an important step in early diagnosis, but barriers to consultation are commonly reported. Understanding barriers to consulting in primary care within the cancer context provides opportunities to improve earlier diagnosis of cancer AIM: To investigate patients' GP consultation preferences when presented with a potential cancer symptom, and to describe whether these preferences are mediated by variable levels of cancer risk...
May 8, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28483035/management-of-patients-brought-in-by-ambulance-to-the-emergency-department-role-of-the-advanced-musculoskeletal-physiotherapist
#12
Rita Kinsella, Tom Collins, Bridget Shaw, James Sayer, Belinda Cary, Andrew Walby, Sallie Cowan
Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED).Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED.Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5 with musculoskeletal complaints were included in the analysis...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28483033/process-to-establish-11-primary-contact-allied-health-pathways-in-a-public-health-service
#13
Michelle Stute, Nicole Moretto, Maree Raymer, Merrilyn Banks, Peter Buttrum, Sonia Sam, Marita Bhagwat, Tracy Comans
Objective Faced with longstanding and increasing demand for specialist out-patient appointments that was unable to be met through usual medical consultant led care, Metro North Hospital and Health Service in 2014-15 established 11 allied health primary contact out-patient models of care.Methods The models involved six different allied health professions and nine specialist out-patient departments.Results All the allied health models have been endorsed for continuation following demonstration of their contribution to managing demand on specialist out-patient services...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#14
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28470074/patient-satisfaction-with-nurse-delivery-primary-health-care-services-in-free-state-and-gauteng-provinces-south-africa-a-comparative-study
#15
Wilfred N Nunu, Pascalia O Munyewende
BACKGROUND: The majority of health care users in South Africa utilise primary health care (PHC) services where these services are free at the point of entry. There is a dearth of knowledge on the factors influencing patient satisfaction with PHC clinic services. AIM: This study compared patient satisfaction with PHC services in the Free State (FS) and Gauteng (GP) provincesSetting: Secondary data analysis was conducted on a cross-sectional survey obtained from the Research on the State of Nursing Project run by the Centre for Health Policy in 2012...
April 28, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28469910/increasing-organ-donor-registration-in-a-primary-care-clinic
#16
Navneet Natt, Erin Klar, Ingrid Cheung, Pavan Matharu, Risa Bordman
Only 30% of Ontarians are registered organ donors in spite of the vast unmet need for organ donations in Ontario, Canada. The purpose of this quality improvement (QI) initiative was to increase the number of registered organ donors in a primary care practice by providing an educational fact sheet and registration form to patients in the clinic's waiting room. Three Plan-Do-Study-Act (PDSA) cycles were conducted. In the first PDSA cycle, we created an information sheet to explain the need for organ donors and the registration process...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28465224/shoe-orthotics-for-the-treatment-of-chronic-low-back-pain-a-randomized-controlled-trial
#17
Jerrilyn A Cambron, Jennifer M Dexheimer, Manuel Duarte, Sally Freels
OBJECTIVES: To investigate the efficacy of shoe orthotics with and without chiropractic treatment for chronic low back pain as compared to no treatment. DESIGN: Randomized Controlled Trial SETTING: An integrative medicine teaching clinic at a Midwestern university. PARTICIPANTS: Two hundred and twenty-five adult subjects with symptomatic low back pain of 3 months or longer were recruited from a volunteer sample. INTERVENTIONS: Subjects were randomized into one of three treatment groups (Orthotics, Plus, and Wait-list Groups)...
April 29, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28463015/effectiveness-of-group-cognitive-behavioral-therapy-for-insomnia-cbt-i-in-a-primary-care-setting
#18
Judith R Davidson, Samantha Dawson, Adrijana Krsmanovic
OBJECTIVE/BACKGROUND: Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. PARTICIPANTS: The patients were 70 women and 11 men (mean age = 57...
May 2, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28458592/patient-perception-of-acute-pain-management-data-from-three-tertiary-care-hospitals
#19
Elsy Ramia, Soumana C Nasser, Pascale Salameh, Aline Hanna Saad
Introduction. The primary objectives of this study were to assess patients' description of their acute pain intensity; patients' attitude towards their pain management during hospitalization; and their overall satisfaction with pain treatment. Methodology. A cross-sectional questionnaire-based study was conducted between October 2014 and March 2015 in three medical centers in Lebanon. All participants' responses were reported using descriptive statistics. The association between categorical variables was evaluated using Pearson χ(2) test or Fisher's exact test where the expected cell count was < 5...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28455884/two-hour-evaluation-and-referral-model-for-shorter-turnaround-times-in-the-emergency-department
#20
John A Burke, Jaimi Greenslade, Jadwiga Chabrowska, Katherine Greenslade, Sally Jones, Jacqueline Montana, Anthony Bell, Alan O'Çonnor
OBJECTIVE: The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. METHODS: A pre-post-intervention study was used to compare ED performance following an extensive clinical redesign programme. Clinical teams and work sequences were reconfigured to promote the role of the staff specialist, with a focus on earlier decisions regarding disposition...
April 28, 2017: Emergency Medicine Australasia: EMA
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