three expectable transition points in primary care

... 2004 Persons at increased risk a Insufficient evidence to recommend for or against routine screening. CDC 2006 Persons at increased risk a Perform routine counseling, testing, and appropriate ... Recommends against routine serological screening for HSV to prevent neonatal HSV infection. a a Women who develop primary HSV infection during pregnancy have highest risk for transmitting HSV infection ... recommends screening. 1. USPSTF makes no recommendation for or against routine screening for HIV in adolescents and adults who are not at increased risk for HIV infection. 2. Initial screening test:

Ngày tải lên: 10/08/2014, 18:21

... Evidence is insufficient to recommend for or against routine screening. Teens with novelty-seeking personality traits are at increased risk of initiating and progressing in smoking behaviors. ... New tests being developed to identify high-risk individuals: noninvasive testing for skin tissue cholesterol; inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, serum amyloid ... residents of long-term care facilities (eg, correctional institutions, mental institutions, nursing homes). b Test: give intradermal injection of 5 U of tuberculin PPD and examine 48–72 hours later.

Ngày tải lên: 10/08/2014, 18:21

... abstain Reinforce and support continued adherence to recommendations.Renegotiate drinking goals as indicated (eg, if the medical condition changes or if an abstaining patient wishes to resume drinking) ... bodily harm (drinking and driving, operating machinery, swimming)relationship trouble (family or friends) role failure (interference with home, work, or school obligations) run-ins with the law ... (tremors, sweating, nausea, or insomnia when trying to quit or cut down) kept drinking despite problems (recurrent physical or psychological problems) spent a lot of time drinking (or anticipating or

Ngày tải lên: 10/08/2014, 18:21

... metabolic syndrome, or those using... basal insulin Add sulfonylurea A1c ≥ 7% A1c ≥ 7% Intensive insulin + metformin +/− glitazone Add basal or intensify insulin = fasting blood glucose ≥ 126 mg/dL ... determination (see page 140) Spot urinoalbumin: creatinine testing preferred Continued surveillance even if treated with ACE or ARB Annual GFR calculation.f Limit protein intake to 0.8 g/kg in ... months after initial diagnosis [...]... causes Nonadherence Inadequate doses Inappropriate combinations Nonsteroidal anti-inflammatory drugs; cyclooxygenase-2 inhibitors Cocaine, amphetamines, other

Ngày tải lên: 10/08/2014, 18:21

... 5APPENDIX I: SCREENING INSTRUMENTSSENSITIVITY AND SPECIFICITY OF SCREENING TESTS FOR PROBLEM DRINKING SCREENING INSTRUMENTS: ALCOHOL ABUSEInstrument Name Screening Questions/Scoring Threshold Score ... given in parentheses Scores range from 0 to 40, with a cutoff score of ≥ 5 indicating hazardous drinking, harmful drinking, or alcohol dependence.) 1) How often do you have a drink containing alcohol? ... screening tool for hazardous alcohol intake and related disorders in primary care: A validity study BMJ 1997;314:420 SCREENING PROCEDURES FOR PROBLEM DRINKING (CONTINUED) Trang 8APPENDIX I: SCREENING

Ngày tải lên: 10/08/2014, 18:21

... receive influenza vaccine. • Influenza vaccine is recommended annually for children aged ≥ 59 months with certain risk factors, health-care workers, and other persons (including household members) in ... vaccine (PPV). (Minimum age: 2 years) • Administer for certain high-risk groups See MMWR 1997;46(No RR-8):1–24, and 5 Influenza vaccine (Minimum age: 6 months for trivalent inactivated influenza ... vaccine [TIV]; 5 years for live, attenuated influenza vaccine [LAIV]) • Influenza vaccine is recommended annually for persons with certain risk factors, care workers, and other persons (including

Ngày tải lên: 10/08/2014, 18:21

... health out-comes in primary care is inconsistent [3,4] In this paper, we consider the structure of the information exchange networks in a primary care practice as a potential determinant of the uptake ... gathering and dissemination informa-tion A study of primary care partnerships in Australia found that independent staff played a crucial role in holding partnerships together [11] A study in the ... understanding is required of appropriate methodologies for collecting and analyzing social network data in primary care set-tings In particular, efficient and effective ways for col-lecting reliable primary

Ngày tải lên: 11/08/2014, 05:21

... Mammogram Td vaccine Flu vaccine Pneumococcal vaccine Hep A vaccines (n> = 2) Chlamydia screening Depression screening Alcohol screening Alcohol counseling Tobacco counseling Diagnosing HTN Blood ... measures within multiple clinical domains, efforts to improve quality in one area may yield a decline in quality in another area In such circumstances, a summary measure may provide clinicians and ... algorithm and preliminary findings were presented to clinicians participating in site visits or attending the 2005 and 2006 PPRNet A-TRIP network meetings, feedback was favorable During site visits,

Ngày tải lên: 11/08/2014, 05:22

... openness to innovation perceive team effectiveness [38] Notably, nurses in primary care practices generally support clinical guidelines, and their role and influence within primary care is in a process ... previous research Developing the clinical team in primary care practice is important to successfully implementing change in practice In a case study of one exemplary primary care practice without ... implement the guidelines Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded

Ngày tải lên: 11/08/2014, 05:22

... health out-comes in primary care is inconsistent [3,4] In this paper, we consider the structure of the information exchange networks in a primary care practice as a potential determinant of the uptake ... gathering and dissemination informa-tion A study of primary care partnerships in Australia found that independent staff played a crucial role in holding partnerships together [11] A study in the ... understanding is required of appropriate methodologies for collecting and analyzing social network data in primary care set-tings In particular, efficient and effective ways for col-lecting reliable primary

Ngày tải lên: 11/08/2014, 16:20

... from an inner city Primary Care Trust in NW England All practice staff were expected to attend two afternoon training sessions The training sessions were observed by members of the training team ... practitioners (GPs), nursing staff and administrative, and support staff Development of the WISE training package The aims of the training are outlined in Table 1 The content of the training package was ... and explain the way in which new or modified practices of thinking, enacting, and organising work associated with WISE are operationa-lised in healthcare In order to understand the embed-ding of

Ngày tải lên: 11/08/2014, 16:20

... reducing clinical inertia in primary care physicians Aim of the study Our program goal is to improve adherence to evidence-based guidelines and to reduce clinical inertia in primary care physicians, ... understanding of existing barriers to high-quality diabetes care and allowed us to incorporate innovative change interventions, such as interdisciplinary teams operating on the primary/spe-cialty care ... evidence-based guidelines for diabetes and reduce clinical inertia in primary care physicians Design: Two-arm cluster randomized controlled trial. Participants: Primary care physicians in Belgium. Interventions:

Ngày tải lên: 11/08/2014, 16:21

... ‘shared’ model of client involvement in decision making, called shared decision making, has received increased interest in both research and clinical settings Shared decision making (SDM) facilitated ... being seen in primary care settings with improved access to evidence-based treatments and compared this to usual care As part of the CCM intervention, participants were informed about, and involved ... children Caregivers reported either themselves or the clinician making the final decision Trust in clinicians was dependant on perceived quality of care Provision of information was poor Caregivers

Ngày tải lên: 11/08/2014, 16:21

... (SOMS-2) in primary care (PC) settings Methods: An adapted version of the SOMS-2 was filled in by persons attending a PC unit All medically unexplained symptoms were further ascertained in a clinical ... clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE) An interview yielded the diagnosis of Clinical ... were obtained by contacting the surgeon in charge Based on all information collected a final con-sensus about the symptom was reached (explained or unexplained), yielding the Final Clinical Symptom

Ngày tải lên: 11/08/2014, 16:22

... use, including calibra-tion, had to meet the American Thoracic Society's criteria [16] Spirometry training was given prior to initiating the study and a repeat training session was given during ... from baseline at the end of the 24-hour dosing interval (i.e 10 minutes prior to drug administration) Baseline FEV1 was the pre-treat-ment FEV1 measured at Visit 2, 10 minutes prior to admin-istration ... to Week 12 Trang 9in a secondary care setting, though further studies oflonger duration are required to confirm our findings Competing interests Daryl Freeman has no shares in pharmaceutical

Ngày tải lên: 12/08/2014, 15:20

... of withdrawing ICS in patients with COPD in secondary care [21,22,24,25] Our findings in primary care patients are broadly similar The COPE study examined time to first exacerbation in 244 COPD ... with COPD in the UK and the Netherlands are managed exclusively in primary care, a figure increasing with the rising awareness and identification particularly of mild COPD in primary care [15,16] ... entry into trial There was no significant difference in reporting of skin bruising, thinning of skin, sore throat, oral thrush or hoarseness of voice between fluticasone and placebo groups during

Ngày tải lên: 12/08/2014, 15:21

... functions (speaking, reading, and writing) – symptoms include: difficulty in thinking of common words while speaking, hesitations; speech, spelling, and writing errors e Changes in personality, ... moments we had during the last years and for shared suffering (including table formatting) Thank you for keeping me in line and standing by my side Trang 5Contents 1 Abstract 1 2 Introduction 4 ... the following points are important In study 1 of this work MCI is defined similar to the NIA-AA core-clinical criteria, however, with an emphasis on episodic memory decline as the defining cognitive

Ngày tải lên: 26/11/2015, 10:00

... health? Maintaining mental wellbeing • sleep as an activity • keeping mentally active • memory Maintaining physical wellbeing • nutrition • pain • keeping physically active Occupation in the home ... and older living at home, in the community, in supported housing or in residential care homes • they included interventions and activities that promote or sustain mental wellbeing in older people, ... dementia and their carers in health and social care, managing depression in primary and secondary care, assessing and preventing falls in older people, obesity, commonly used methods to increase physical...

Ngày tải lên: 05/03/2014, 18:20

... difficulties in disseminating research findings to primary care providers Research on implementing screening and brief alcohol intervention showed personal meetings to effect most behaviour change in GPs, ... interviewing techniques should be considered when delivering brief interventions for harmful drinking in primary care Staff who deliver motivational interviewing should be appropriately trained 1+ ... the primary care team includes: n n n n n n n n n n initial discussion and support advice regarding non-hazardous drinking levels and ways to reduce drinking counselling and therapy for the individual...

Ngày tải lên: 08/03/2014, 14:20

... higher cost increments A similar phenomenon was observed using the BPI using the pain interference index For example, an increase in the degree of pain interference by point (0- to 10-point scale) ... grouped according to pain intensity (Figure 2) Direct health care costs and pain intensity due to FM were driven largely by pharmacological costs (Figure 3) However, pain interference in general ... chest pain Furthermore, there should be pain to touch in at least 11 out of the following 18 symmetric points: occipital, low cervical, trapezium, supraspinal, second intercostal space in the...

Ngày tải lên: 09/08/2014, 14:20