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family practice in Canada

John R Broughton, Herenia P Lawrence, Lisa Jamieson
: Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand. OBJECTIVE: To conduct the research in New Zealand using a kaupapa Māori (Māori philosophy) approach. METHODS: This is a mixed-method study incorporating quantitative and qualitative data whilst acknowledging Māori cultural practices by the utilization of Te Whare Tapa Whā, a model for Māori health and well-being...
2016: Journal of Health Care for the Poor and Underserved
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Dawn Schroeder, Wendy Duggleby, Brenda L Cameron
BACKGROUND: In families where genetic testing for the breast cancer 1 and 2 genes (BRCA1/2) has not identified a deleterious mutation, the risk for hereditary breast cancer (HBC) can still be high when there is a strong family history. Little is known about how an awareness of risk for HBC impacts the everyday lives of unaffected women (no personal history for breast and/or ovarian cancer) in these families. OBJECTIVE: The aim of this study is to explore how unaffected women, living in BRCA1/2-negative families, experience living with risk for HBC...
October 4, 2016: Cancer Nursing
Amanda van Beinum, Laura Hornby, Sonny Dhanani, Roxanne Ward, Jane Chambers-Evans, Kusum Menon
Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies...
October 13, 2016: Journal of Medical Ethics
Yi-Sheng Chao, Antoine Boivin, Isabelle Marcoux, Geneviève Garnon, Nicholas Mays, Pascale Lehoux, Marie-Claude Prémont, Evert van Leeuwen, Raynald Pineault
BACKGROUND: End-of-life policies are hotly debated in many countries, with international evidence frequently used to support or oppose legal reforms. Existing reviews are limited by their focus on specific practices or selected jurisdictions. The objective is to review international time trends in end-of-life practices. METHODS: We conducted a systematic review of empirical studies on medical end-of-life practices, including treatment withdrawal, the use of drugs for symptom management, and the intentional use of lethal drugs...
October 3, 2016: BMC Health Services Research
A K Lofters, M Slater, M Vahabi
Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice...
October 6, 2016: Journal of Immigrant and Minority Health
Maryam Oskoui, Pamela Ng, Stephen Liben, David Zielinski
BACKGROUND: Increasing numbers of families are requesting active supportive management for their child with spinal muscular atrophy type 1 (SMA1), leading to longer survival and greater prevalence of affected children. Strong opinions exist among physicians for and against the provision of care measures prolonging life. OBJECTIVE: To describe current practice in the care of SMA1 in Canada, and explore the factors underlying inter-physician variability. METHODS: A cross-sectional survey of Canadian hospital-based pediatric neurologists and pediatric respirologists was performed in 2015...
September 29, 2016: Pediatric Pulmonology
Nancy Carter, Esther Sangster-Gormley, Jenny Ploeg, Ruth Martin-Misener, Faith Donald, Abigail Wickson-Griffiths, Sharon Kaasalainen, Carrie McAiney, Kevin Brazil, Alan Taniguchi, Lori Schindel Martin
The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members...
2016: Nursing Leadership
Elizabeth Ford, Judy Shakespeare, Fatin Elias, Susan Ayers
BACKGROUND: Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. METHOD: A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted...
September 22, 2016: Family Practice
Pasquale Roberge, Catherine Hudon, Alan Pavilanis, Marie-Claude Beaulieu, Annie Benoit, Hélène Brouillet, Isabelle Boulianne, Anna De Pauw, Serge Frigon, Isabelle Gaboury, Martine Gaudreault, Ariane Girard, Marie Giroux, Élyse Grégoire, Line Langlois, Martin Lemieux, Christine Loignon, Alain Vanasse
BACKGROUND: The prevalence of comorbid anxiety and depressive disorders is high among patients with chronic diseases in primary care, and is associated with increased morbidity and mortality rates. The detection and treatment of common mental disorders in patients with chronic diseases can be challenging in the primary care setting. This study aims to explore the perceived needs, barriers and facilitators for the delivery of mental health care for patients with coexisting common mental disorders and chronic diseases in primary care from the clinician and patient perspectives...
2016: BMC Family Practice
Jamie M Boyd, Rachael Burton, Barb L Butler, Dianne Dyer, David C Evans, Melissa Felteau, Russell L Gruen, Kenneth M Jaffe, John Kortbeek, Eddy Lang, Val Lougheed, Lynne Moore, Michelle Narciso, Peter Oxland, Frederick P Rivara, Derek Roberts, Diana Sarakbi, Karen Vine, Henry T Stelfox
OBJECTIVE: The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. BACKGROUND: Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. METHODS: Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups...
September 8, 2016: Annals of Surgery
Mylaine Breton, Lara Maillet, Isabelle Paré, Sabina Abou Malham, Nassera Touati
In Quebec, several primary care physicians have made the transition to the advanced access model to address the crisis of limited access to primary care. The objectives are to describe the implementation of the advanced access model, as perceived by the first family physicians; to analyze the factors influencing the implementation of its principles; and to document the physicians' perceptions of its effects on their practice, colleagues and patients. Qualitative methods were used to explore, through semi-structured interviews, the experiences of 21 family physicians who had made the transition to advanced access...
September 8, 2016: International Journal of Health Planning and Management
Bartha Maria Knoppers, Minh Thu Nguyen, Karine Sénécal, Anne Marie Tassé, Ma'n H Zawati
The impact of next-generation sequencing (NGS) on the issue of return of results is defying clear policy guidance and creating international confusion. Limiting ourselves to the return of results revealed by NGS (including incidental findings) in adults, children, family members of deceased individuals, and population studies, we describe and contrast emerging policy positions in Europe, Canada, and the United States. Until there are clear, scientific, and professional standards and practical policy, both researchers and clinicians cannot be faulted for being either hesitant or pressured to return NGS results...
October 3, 2016: Cold Spring Harbor Perspectives in Medicine
Catherine Deri Armstrong, Monica Taljaard, William Hogg, Amy E Mark, Clare Liddy
BACKGROUND: Practice facilitation (PF), a multifaceted approach in which facilitators (external health care professionals) help family physicians to improve their adoption of best practices, has been highly successful. Improved Delivery of Cardiovascular Care (IDOCC) was an innovative PF trial designed to improve evidence-based care for people who have, or are at risk of, cardiovascular disease (CVD). The intervention was found to be ineffective as assessed by a patient-level composite score based on chart reviews from a subsample of patients (N = 5292)...
2016: Trials
June C Carroll, Roland Grad, Judith E Allanson, Pierre Pluye, Joanne A Permaul, Nicholas Pimlott, Brenda J Wilson
INTRODUCTION: Primary care providers (PCP) will need to be integrally involved in the delivery of genomic medicine. The GenetiKit trial demonstrated effectiveness of a knowledge translation intervention on family physicians' (FP) genetics referral decision-making. Most wanted to continue receiving Gene Messengers (GM), evidence-based summaries of new genetic tests with primary care recommendations. Our objective was to determine the value of GMs as a continuing education (CE) strategy in genomic medicine for FPs...
2016: Journal of Continuing Education in the Health Professions
Renee Carter, Jean-Frédéric Lévesque, Sam Harper, Amélie Quesnel-Vallée
The Family Medicine Group (FMG) model of primary care in Quebec, Canada, was driven by the voluntary implementation of family physicians. Our main objective was to measure the effect of FMG enrolment on avoidable use of the emergency department (ED) by diabetic patients. We also sought to determine if effects differed according to whether patients were infrequent or frequent users of the ED and according to high- versus low-regional levels of enrolment. We used data from provincial health administrative databases to identify the diabetic patient population over the age of 20 years for each fiscal year between 2003-2004 and 2011-2012...
August 30, 2016: Journal of Evaluation in Clinical Practice
Mandana Vahabi, Aisha Lofters
BACKGROUND: Canada has observed significant decreases in incidence and mortality of cervical cancer in recent decades, and this has been attributed to appropriate screening (i.e., the Pap test). However, certain subgroups including Muslim immigrants show higher rates of cervical cancer mortality despite their lower incidence. Low levels of screening have been attributed to such barriers as lack of a family physician, inconvenient clinic hours, having a male physician, and cultural barriers (e...
2016: BMC Public Health
Alberico L Catapano, Dominik Lautsch, Lale Tokgözoglu, Jean Ferrieres, Martin Horack, Michel Farnier, Peter P Toth, Philippe Brudi, Joanne E Tomassini, Baishali Ambegaonkar, Anselm K Gitt
BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a life-threatening disease, characterized by elevated LDL-C levels and a premature, increased risk of coronary heart disease (CHD) that is globally underdiagnosed. The percentage of patients with possible or probable FH in various countries was examined in the Dyslipidemia International Study (DYSIS). METHODS: DYSIS is a multinational, cross-sectional observational study of 54,811 adult outpatients treated with statin therapy...
September 2016: Atherosclerosis
Mélanie Lavoie-Tremblay, Nancy Feeley, Geneviève L Lavigne, Christine Genest, Stéphanie Robins, Julie Fréchette
There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit...
July 2016: Health Care Manager
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
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