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Family practice office

Karol Kumpfer, Catia Magalhães, Jing Xie
Family evidence-based interventions (FEBIs) are effective in creating lasting improvements and preventing children's behavioral health problems, even in genetically at-risk children. Most FEBIs, however, were designed for English-speaking families. Consequently, providers have difficulty engaging non-English-speaking populations in their own country or in other countries where the content, language, and recruitment methods of the FEBIs do not reflect their culture. The practical solution has been to culturally adapt existing FEBIs...
October 18, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Martin Dawes, Martin N Aloise, J Sidney Ang, Pieter Cullis, Diana Dawes, Robert Fraser, Gideon Liknaitzky, Andrea Paterson, Paul Stanley, Adriana Suarez-Gonzalez, Hagit Katzov-Eckert
BACKGROUND: Inappropriate prescribing increases patient illness and death owing to adverse drug events. The inclusion of genetic information into primary care medication practices is one solution. Our aim was to assess the ability to obtain and genotype saliva samples and to determine the levels of use of a decision support tool that creates medication options adjusted for patient characteristics, drug-drug interactions and pharmacogenetics. METHODS: We conducted a cohort study in 6 primary care settings (5 family practices and 1 pharmacy), enrolling 191 adults with at least 1 of 10 common diseases...
July 2016: CMAJ Open
Paul-Georges Reuter, Thibaut Desmettre, Sabine Guinemer, Olivier Ducros, Stéphane Begey, Agnès Ricard-Hibon, Laurianne Billier, Océane Grignon, Isabelle Megy-Michoux, Jean-Noël Latouff, Adeline Sourbes, Julien Latier, Isabelle Durand-Zaleski, Frédéric Lapostolle, Eric Vicaut, Frédéric Adnet
BACKGROUND: Telephone consultations in general practice are on the increase. However, data on their efficiency in terms of out-of-hours general practitioner (GP) workload, visits to hospital emergency departments (ED), cost, patient safety and satisfaction are relatively scant. The aim of this trial is to assess the effectiveness of telephone consultations provided by French emergency call centres in patients presenting with isolated fever or symptoms of gastroenteritis, mainly encountered diseases...
2016: Trials
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Merrick Zwarenstein, Jeremy M Grimshaw, Justin Presseau, Jill J Francis, Gaston Godin, Marie Johnston, Martin P Eccles, Jacqueline Tetroe, Susan K Shiller, Ruth Croxford, Diane Kelsall, J Michael Paterson, Peter C Austin, Karen Tu, Lingsong Yun, Janet E Hux
BACKGROUND: Evidence on the effectiveness of printed educational messages in contributing to increasing evidence-based clinical practice is contradictory. Nonetheless, these messages flood physician offices, in an attempt to promote treatments that can reduce costs while improving patient outcomes. This study evaluated the ability of printed educational messages to promote the choice of thiazides as the first-line treatment for individuals newly diagnosed with hypertension, a practice supported by good evidence and included in guidelines, and one which could reduce costs to the health care system...
2016: Implementation Science: IS
Jeffrey D Ho, Donald M Dawes, Evan M McKay, Jeremy J Taliercio, Scott D White, Blair J Woodbury, Mark A Sandefur, James R Miner
INTRODUCTION: Current Emergency Medical Services (EMS) documentation practices usually occur from memory after an event is over. While this practice is fairly standard, it is unclear if it can introduce significant error. Modern technology has seen the increased use of recorded video by society to more objectively document notable events. Stationary mounted cameras, cell-phone cameras, and law enforcement officer Body-Worn Cameras (BWCs) are increasingly used by society for this purpose...
September 16, 2016: Prehospital Emergency Care
Michael Lee-Poy, Moira Stewart, Bridget L Ryan, Judith Belle Brown
OBJECTIVE: To examine family physicians' practices in and opinions on asking patients about their religious and spiritual beliefs, as well as physicians' comfort levels in asking. DESIGN: Cross-sectional study using self-administered questionnaires. SETTING: Kitchener-Waterloo, Ont. PARTICIPANTS: A total of 155 family physicians with office practices. MAIN OUTCOME MEASURES: Frequency of asking patients about their religious and spiritual beliefs and physicians' comfort levels in asking...
September 2016: Canadian Family Physician Médecin de Famille Canadien
Christine Sinsky, Lacey Colligan, Ling Li, Mirela Prgomet, Sam Reynolds, Lindsey Goeders, Johanna Westbrook, Michael Tutty, George Blike
Background: Little is known about how physician time is allocated in ambulatory care. Objective: To describe how physician time is spent in ambulatory practice. Design: Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours). Setting: U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington). Participants: 57 U...
September 6, 2016: Annals of Internal Medicine
Teresa Cutts, Sandra Holmes, Archana Kedar, Karen Beatty, Mohammad K Mohammad, Thomas Abell
BACKGROUND: Gastroparesis (Gp) is a poorly understood chronic gastrointestinal medical condition for which patient reported outcomes (PRO) are lacking. Previously developed symptoms scoring has been used for several decades. Using symptoms scores as a basis for documentation, 12 years of support/focus group patient feedback from the nearly 1000 attendees were integrated with medical care and recommendations for treatment were developed. Early attenders of the support group were compared with non-attendees for illness acuity, disability, and duration and number of office phone calls...
2016: BMC Gastroenterology
Nicolas Mottet, Joaquim Bellmunt, Michel Bolla, Erik Briers, Marcus G Cumberbatch, Maria De Santis, Nicola Fossati, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Vsevolod B Matveev, Paul C Moldovan, Roderick C N van den Bergh, Thomas Van den Broeck, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Ivo G Schoots, Thomas Wiegel, Philip Cornford
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostate cancer (PCa). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated and the levels of evidence and/or grades of recommendation were added based on a systematic review of the evidence...
August 25, 2016: European Urology
E P Vamos, E Lewis, C Junghans, E Hrobonova, E Dunsford, C Millett
OBJECTIVES: Go-Golborne is a pilot intervention to prevent childhood obesity in the Royal Borough of Kensington and Chelsea between 2014 and 2018. It is a multistrategy approach targeting children aged 0-16 years and their families in all settings where children live, learn and play. This paper describes the methodology and the practical steps in the development of Go-Golborne. STUDY DESIGN: The programme uses a quasi-experimental design for the evaluation of changes in weight status using data from the extended National Child Measurement Programme across local schools...
August 23, 2016: Public Health
Obehi Aituaje Akoria
BACKGROUND: Unawareness of the peculiar healthcare needs of the elderly and resource constraints may be some reasons why until recently, Nigerian hospitals have not been equipped with the human and infrastructural resources required to meet older adults' special healthcare needs. There is paucity of specialized health services for the elderly in Africa. Nigeria, with a population of over 170 million, did not have any healthcare facility with dedicated services for the elderly until 2012...
July 2016: Annals of African Medicine
R Burkhardt, W Pankow
In general chronic obstructive pulmonary disease (COPD) can be diagnosed in family practice from history and spirometry. Inconclusive spirometry findings have to be assessed further by techniques available in a pulmonologist's office. Further testing is done for differential diagnostic reasons and for prognostic appraisal. Successful smoking cessation importantly alters the natural downhill course of the disease. Patient education and rehabilitative interventions (e. g. participation in lung sport groups) help to improve life quality...
August 2016: Pneumologie
Dian Baker, Lori Anderson, Jody Johnson
In 2016 the National Association of School Nurses released an updated framework for school nurse practice. One highlight of the new framework is 21st century care coordination. That is, moving beyond basic case management to a systems-level approach for delivery of school health services. The framework broadly applies the term care coordination to include direct care and communication across systems. School nurses are often engaged in efforts to create school health care homes that serve as an axis of coordination for students and families between primary care offices and the schools...
August 1, 2016: NASN School Nurse
Taddese Alemu Zerfu, Melaku Umeta, Kaleab Baye
BACKGROUND: The nutritional status of women before and during pregnancy can be determined by maternal knowledge, attitudes, and perceptions towards certain foods. The present study aimed to explore maternal dietary habits, food taboos, and cultural beliefs that can affect nutrition during pregnancy in rural Arsi, central Ethiopia. METHODS: A qualitative, cross-sectional study, involving 38 key informant in-depth interviews and eight focus group discussions, was conducted among purposefully selected pregnant women and their husbands, elderly people, community leaders, health workers, and agriculture office experts...
2016: Journal of Health, Population, and Nutrition
Raman Kumar
Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level...
January 2016: Journal of Family Medicine and Primary Care
J Clinton, A F Feller, R C Williams
A clear understanding of infant mental health will significantly assist a clinician's ability to provide high-quality paediatric care for children and their families, given the new understanding of its role in overall development. The present commentary describes the mental health needs of children <3 years of age and provides practical suggestions for the office setting.
June 2016: Paediatrics & Child Health
Stephen M Modell, Karen Greendale, Toby Citrin, Sharon L R Kardia
DESCRIPTION: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics...
2016: Healthcare (Basel, Switzerland)
Nishant Raj Pandey
Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general practitioners/family physicians or house officers...
December 2016: International Journal of Emergency Medicine
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