MedWorm: Primary Care

Index

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

(Source: Primary Care: Clinics in Office Practice)

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Intrapartum Care the Midwifery Way: A Review

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

Midwifery offers concepts and techniques for intrapartum care that could be integrated into the practice of a family physician. Normal birth has virtually been replaced by a medicalized model of maternity care in the American health care system, despite research indicating that many interventions are not necessary and even harmful. A low-tech, high-touch approach to low-risk women in labor is evidence based and results in improved perinatal outcomes as well as higher patient satisfaction with the birth experience. (Source: Primary Care: Clinics in Office Practice)

Postpartum Hemorrhage

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

Postpartum hemorrhage (PPH) is a very common obstetric emergency with high morbidity and mortality rates worldwide. Understanding its etiology is fundamental to effectively managing PPH in an acute setting. Active management of the third stage of labor is also a key component in its prevention. Management strategies include conservative measures (medications, uterine tamponade, and arterial embolization) as well as surgical interventions (arterial ligations, compression sutures, and hysterectomy). Creating a standardized PPH protocol and running simulation-based drills with a multidisciplinary team may also help decrease maternal morbidity and improve perinatal outcomes, although further studies are needed. (Source: Primary Care: Clinics in Office Practice)

Cesarean Delivery

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

Cesarean delivery rates rose from 20 to 33% of births in the United States from 2006-2009 without an accompanying improvement in neonatal outcomes. The cesarean rate may be safely decreased by increasing vaginal birth after cesarean, encouraging external cephalic version for breech presentation, maintaining operative vaginal delivery skills, and applying stricter criteria for operative intervention in labor dystocia. A variety of cesarean operative techniques are supported by randomized controlled trials. Optimal maternity care outcomes depend on sound medical decision-making, appropriate operative technique and skills, and effective communication between maternity care team members. (Source: Primary Care: Clinics in Office Practice)

Electronic Fetal Monitoring: Family Medicine Obstetrics

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

This article summarizes the development, interpretation, and management of electronic fetal heart rate patterns and tracings. (Source: Primary Care: Clinics in Office Practice)

Third-Trimester Pregnancy Complications

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

This article guides the practitioner through decision-making and management of these problems. (Source: Primary Care: Clinics in Office Practice)

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Genetic Screening and Counseling: Family Medicine Obstetrics

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

This article reviews these concerns and provides a framework for training in family medicine obstetrics training. (Source: Primary Care: Clinics in Office Practice)

Family Medicine Obstetrics: Pregnancy and Nutrition

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

This article discusses pregnancy and nutrition in 3 main timeframes, the prepregnancy nutritional health evaluation, nutrition during pregnancy, and nutrition during the puerperium, and also includes comments on nutrition and lactation. This article begins with a brief review of the risks of obesity (increased body mass index [BMI]) and anorexia (decreased BMI), with special attention to these undesired conditions during pregnancy, followed by a section on nutrients other than calories. Information on body weight, minerals, and vitamins during pregnancy is reviewed. This article ends with information on nutrition in the postpartum period. (Source: Primary Care: Clinics in Office Practice)

Forthcoming Issues

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

(Source: Primary Care: Clinics in Office Practice)

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

(Source: Primary Care: Clinics in Office Practice)

Contributors

Primary Care: Clinics in Office Practice — Thu, 09 Feb 2012 06:32:26 +0100

(Source: Primary Care: Clinics in Office Practice)

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Thank you to Reviewers

Maturitas — Thu, 09 Feb 2012 06:32:18 +0100

(Source: Maturitas)

Editorial Board

Maturitas — Thu, 09 Feb 2012 06:32:18 +0100

(Source: Maturitas)

Billing and Collections: Best Practices

Consultant Live — Thu, 09 Feb 2012 06:30:01 +0100

These days, every dollar counts. Here are out top tips for making sure you collect what you are owed. A few simple steps can make a big difference in your bottom line. (Source: Consultant Live)

Bridging the gap

OnMedica Views — Thu, 09 Feb 2012 05:00:00 +0100

Do salaried GPs have a “clock watch attitude” or are they “over burdened” by GP partners? Find out about the views from both professional groupsRelated items from OnMedicaNew support for GP consortiaDoctors reject government's latest pension offerHundreds of GPs slam the health reformsGMS Contract “should incentivise integration”NHS reliant on doctors working ‘goodwill’ hours (Source: OnMedica Views)

Many Doctors May Be Less Than Honest With Their Patients

Primary Care News - Doctors Lounge — Thu, 09 Feb 2012 05:00:00 +0100

Survey found one in 10 lied, many painted too rosy a prognosis (Source: Primary Care News - Doctors Lounge)

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The Healthy Teens Initiative: a collaborative model for improving access to highly effective contraception for adolescents

Contraception — Thu, 09 Feb 2012 03:36:55 +0100

To describe the impact of a collaborative quality improvement model for increasing access to highly effective contraception for adolescents visiting community health centers. The New York City Department of Health and Mental Hygiene's Healthy Teens Initiative led multidisciplinary teams from community health centers through a collaborative program to increase access to contraception among sexually active adolescents. Two cohorts participated: 8 in 2009 (1 was a primary care site) and 10 in 2010 (9 were primary care sites). To assess the impact of the initiative, data were collected to track changes in contraceptive coverage, the proportion of female patients aged 12-19 receiving contraception, and, in QuickStart prevalence, the proportion of visits where contraception was dispensed using ...

Honesty Is a Sometimes Policy for Many PhysiciansHonesty Is a Sometimes Policy for Many Physicians

Medscape Today Headlines — Thu, 09 Feb 2012 01:18:18 +0100

One in 10 physicians report having lied to a patient within the previous 12 months, while 1 in 5 did not fully disclose a medical mistake because they feared a lawsuit, according to a new study. Medscape Medical News (Source: Medscape Today Headlines)

Heart disease risk passes from father to son, study finds

HealthcareRepublic Pharmacist News — Thu, 09 Feb 2012 00:01:00 +0100

Risk of heart disease is inherited on the Y chromosome, according to groundbreaking UK research. (Source: HealthcareRepublic Pharmacist News)

Education program cuts antibiotic dispensing in primary care

MedWire News - Infectious Diseases — Wed, 08 Feb 2012 22:48:34 +0100

An educational program successfully reduced the rate of antibiotic dispensing in primary care, UK research published in the British Medical Journal shows. (Source: MedWire News - Infectious Diseases)

Adherence to national guidelines for surveillance after curative resection of nonmetastatic colon and rectum cancer: a survey among Norwegian gastrointestinal surgeons

Colorectal Disease — Wed, 08 Feb 2012 21:05:13 +0100

Conclusion All hospitals reported having a strategy for surveillance after surgery for colon and rectal cancer, but there was considerable variance in strategy. A scientific audit of the true level of compliance, effectiveness and cost‐benefit is warranted at a national level. (Source: Colorectal Disease)

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PPI Ineffective for Asthma Control in Children With No GERD Symptoms

AAFP Health of the Public — Wed, 08 Feb 2012 18:10:00 +0100

An acid reflux drug frequently prescribed for children with poorly controlled asthma does not improve asthma control if the child has no symptoms of acid reflux, according to a recent study published in JAMA: the Journal of the American Medical Association (Source: AAFP Health of the Public)

Health Highlights: Feb. 8, 2012

Primary Care News - Doctors Lounge — Wed, 08 Feb 2012 16:00:00 +0100

U.S. Teen Pregnancy Rate at 40-Year Low Ulcer, Acid Reflux Drugs May Raise Risk of Diarrhea: FDA Walmart Introduces New Healthy Food Standards, Labels FDA Should Review Inhaled Caffeine Product: Senator White House Aims to Ease Religious Groups' Concerns About Contraception Rule More Autism-Friendly Musicals on Broadway (Source: Primary Care News - Doctors Lounge)

Behavioral EconomicsBehavioral Economics

Medscape Today Headlines — Wed, 08 Feb 2012 15:35:24 +0100

Medscape talked to Richard Roberts, MD, AAFP Foundation president, about a demonstration program in diabetes using behavioral economics, which combines 2 standard disciplines to improve healthcare. Medscape Family Medicine (Source: Medscape Today Headlines)

NICE to develop formulary rules 'to tackle drug postcode lottery'

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 14:25:00 +0100

A best-practice guide to establishing local formularies will aim to tackle the postcode lottery faced by patients trying to access NHS drugs. (Source: HealthcareRepublic Pharmacist News)

GPs told to investigate obesity in last minute of consultation

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 14:20:00 +0100

GPs must use the last minute of consultations with obese patients to discuss their weight to tackle the harm caused by comorbidities, a GP expert has urged. (Source: HealthcareRepublic Pharmacist News)

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Only Take Contracts That Pay Enough

Consultant Live — Wed, 08 Feb 2012 12:00:00 +0100

You really don't have to accept every manager care contract that comes your way, even if it means losing patients. Know your costs to choose right. (Source: Consultant Live)

Antihypertensive Drugs for the Elderly: Too Much of a Good Thing

Consultant Live — Wed, 08 Feb 2012 12:00:00 +0100

Dizzy patient? Their brain might not be getting enough blood, thanks to their antihypertensive dosage. (Source: Consultant Live)

Physician Wages in States with Expanded APRN Scope of Practice

Clinical and Developmental Immunology — Wed, 08 Feb 2012 11:20:54 +0100

In recent years, states have looked to reforms in advanced practice nursing scope of practice (SOP) barriers as a potential means to increase access to primary care while reducing costs. Currently, 16 states and the District of Columbia permit advanced practice registered nurses to practice independently of physicians, allowing them to perform functions such as diagnosing and prescribing under their own authority within the primary care setting. Given the resistance of many physician associations to these reforms, we asked whether the economic interests of primary care physicians might be affected by reforms. Using the Bureau of Labor Statistics data on earnings, we compared primary care physicians' earnings in states that have instituted SOP reforms to those that maintain these practi...

BMA leaders call for Lansley to quit as Lords prepare to debate reforms

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 10:46:00 +0100

BMA leaders in London called for health secretary Andrew Lansley to resign as the House of Lords prepared to debate proposed amendments to the Health Bill. (Source: HealthcareRepublic Pharmacist News)

Elderly 'passed like parcels' in care system, say MPs

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 10:01:00 +0100

Clinical commissioning groups (CCGs) should create a single process for buying health and social care for older people, according to MPs. (Source: HealthcareRepublic Pharmacist News)

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The impact of lung cancer on patients and carers.

Chronic Respiratory Disease — Wed, 08 Feb 2012 09:06:02 +0100

This article aims to provide a brief review of the literature with regard to the impact of lung cancer on patients and their informal carers. Compared to other types of cancer, the distress associated with lung cancer has been found to be the most intense. Rather than focusing on symptoms in isolation recent emphasis regarding the symptom experience has been on symptoms clusters, as understanding these clusters may improve the management of ongoing and unrelieved symptoms. However, the disparities in methodology are significant barriers to producing comparable results, although recent efforts have been made to address these. Whilst research into symptoms has enormous potential for the management of symptom clusters, it needs to move away from the essentially reductionist stance which curre...

Study Examines Misconceptions Of Who Picks Up Tab When Patients Walk Out

Health News from Medical News Today — Wed, 08 Feb 2012 08:00:00 +0100

There are ways in which patients who leave the hospital against medical advice wind up paying for that decision. Being saddled with the full cost of their hospital stay, however, is not one of them. Insurance companies know this. Patients who walk out may know this. But many physicians, according to a study published in the Journal of General Internal Medicine, do not... (Source: Health News from Medical News Today)

Exemestane Associated with Increased Bone Loss in Postmenopausal Women

Physician's First Watch current issue — Wed, 08 Feb 2012 05:00:00 +0100

(Source: Physician's First Watch current issue)

Bread, Poultry Account for Large Part of America's Sodium Consumption

Physician's First Watch current issue — Wed, 08 Feb 2012 05:00:00 +0100

(Source: Physician's First Watch current issue)

Intussusception Risk Not Elevated with Pentavalent Rotavirus Vaccine

Physician's First Watch current issue — Wed, 08 Feb 2012 05:00:00 +0100

(Source: Physician's First Watch current issue)

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Teaching Teachers to Teach (Frances E Biagioli MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Wed, 08 Feb 2012 05:00:00 +0100

Discussion for the Medical Student Education STFM conference in Long Beach California. 2012 (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Identifying the Motivators, Challenges and Faculty Development Needs for Senior Faculty in Medical Student Education (William B Shore MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Wed, 08 Feb 2012 05:00:00 +0100

(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

A Model for a Free Student-Run Mental Health Clinic (Weill Cornell Community Clinic)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Wed, 08 Feb 2012 05:00:00 +0100

Current resources are inadequate to meet the demand for mental health services. This inadequacy is particularly evident in the case of uninsured patients in New York City. Even when care is initially provided, obstacles such as financial instability often disrupt follow-up and continued care. As a result, there is a large and growing population of mentally disabled individuals who are in need of mental health services but are not receiving them. In an effort to address this problem, a free student-run, attending-directed, mental health clinic was established under the auspices of the student-run Weill Cornell Community Clinic (WCCC). To our knowledge, it is the first psychiatric outpatient clinic of its kind. In the student-run clinic setting, psychiatric care is typically provided by volu...

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

BMC Family Practice — Wed, 08 Feb 2012 05:00:00 +0100

Conclusions: Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings. (Source: BMC Family Practice)

ACP to Congress: Don’t cut primary care workforce programs

Modern Medicine — Wed, 08 Feb 2012 05:00:00 +0100

The American College of Physicians urged Congress not to cut funding for the National Health Services Corps. Learn why the ACP says it’s so important. (Source: Modern Medicine)

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Best Practice in Primary Care Pathology: Review 14Best Practice in Primary Care Pathology: Review 14

Medscape Today Headlines — Wed, 08 Feb 2012 04:00:00 +0100

This best practice review examines the appropriateness of tumor marker measurement for three oft-requested markers in primary care: CA-125, HGC, and AFP. Journal of Clinical Pathology (Source: Medscape Today Headlines)

GP practices face £200k cut in GMS contract reform

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 00:05:00 +0100

Practices could face six-figure swings in funding under NHS-backed plans to base practice budgets on QOF data, accountants have warned. (Source: HealthcareRepublic Pharmacist News)

NHS panel says publishing GP outcomes data can cut postcode lotteries

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 00:04:00 +0100

Practice data on outcomes and activity should be published to eliminate postcode lotteries in access to 'low clinical value' treatments, an NHS panel has concluded. (Source: HealthcareRepublic Pharmacist News)

Generalists Need Education on HF Treatment Generalists Need Education on HF Treatment

Medscape Today Headlines — Tue, 07 Feb 2012 22:27:37 +0100

A unique study trying to drill down into why cardiologists seem to gain better outcomes than generalists when treating heart failure has identified a number of reasons that this is the case. But generalists--who treat the majority of HF--have to deal with older and sicker patients, confounding the issue. The authors hope the work will act as a catalyst to improve HF care. Heartwire (Source: Medscape Today Headlines)

Ovarian Cancer Screening Common Despite Lack of Proof (CME/CE)

MedPage Today Public Health — Tue, 07 Feb 2012 18:44:38 +0100

(MedPage Today) -- More than 90% of primary care physicians reported ordering ovarian cancer screening tests not recommended for women with a low or average risk for the disease, a national survey showed. (Source: MedPage Today Public Health)

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DH reveals details of CCG share of NHS funding

HealthcareRepublic Pharmacist News — Tue, 07 Feb 2012 16:18:00 +0100

The DH has published details of how NHS funding currently managed by PCTs will be split between clinical commissioning groups (CCGs) and the NHS Commissioning Board (NCB). (Source: HealthcareRepublic Pharmacist News)

BMA demands pension talks after meeting with Lansley

HealthcareRepublic Pharmacist News — Tue, 07 Feb 2012 15:56:00 +0100

The BMA has launched a petition demanding meaningful talks after a meeting between the union and health secretary Andrew Lansley last week failed to break the deadlock on pension reforms. (Source: HealthcareRepublic Pharmacist News)

Prevalence of Mental Disorders and Profile of Disablement among Primary Health Care Service Users in Lagos Island

Journal of Nanomaterials — Tue, 07 Feb 2012 14:50:03 +0100

Conclusion. These findings are a useful guide to the probable prevalence of psychiatric morbidity in primary care in Nigeria and in the design of appropriate interventions. (Source: Journal of Nanomaterials)

Get Happy Front Desk Staff

Consultant Live — Tue, 07 Feb 2012 12:00:00 +0100

Your front desk staff create the first impression for your patients. Make sure they play the role well. (Source: Consultant Live)

Appetite Loss in the Elderly

Consultant Live — Tue, 07 Feb 2012 12:00:00 +0100

Geriatric anorexia might be a sign of illness -- or simple oral discomfort (Source: Consultant Live)

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GPs urged to check leases or face bills for thousands of pounds

HealthcareRepublic Pharmacist News — Tue, 07 Feb 2012 10:10:00 +0100

GPs could face a bill for thousands of pounds in building repairs unless they have up-to-date premises leases in place with their PCT by April 2013. (Source: HealthcareRepublic Pharmacist News)

NHS Commissioning Board under fire for lack of primary care representation

HealthcareRepublic Pharmacist News — Tue, 07 Feb 2012 09:53:00 +0100

Two of the most passionate supporters of commissioning have voiced fears that the NHS Commissioning Board (NCB) is short of primary care representation. (Source: HealthcareRepublic Pharmacist News)

Health Highlights: Feb. 6, 2012

MedicineNet Mens Health General — Tue, 07 Feb 2012 07:00:00 +0100

Title: Health Highlights: Feb. 6, 2012Category: Health NewsCreated: 2/6/2012 2:05:00 PMLast Editorial Review: 2/7/2012 (Source: MedicineNet Mens Health General)

Insomnia

MedicineNet Menopause General — Tue, 07 Feb 2012 07:00:00 +0100

Title: InsomniaCategory: Diseases and ConditionsCreated: 6/6/2005Last Editorial Review: 2/7/2012 (Source: MedicineNet Menopause General)

Management and outcome of severely elevated blood pressure in primary care: A prospective observational study.

Swiss Medical Weekly — Tue, 07 Feb 2012 05:36:02 +0100

CONCLUSION: The majority of 164 patients who presented with acutely and severely elevated blood pressure (BP >180 +/or >110 mm Hg) to their GPs was asymptomatic, had pre-existing hypertension and was managed in GP's office unless a hypertensive emergency was present. At three month follow-up mean systolic BP was still above target values. PMID: 22287296 [PubMed - in process] (Source: Swiss Medical Weekly)

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Nutrition Counseling Initiative at the Weill Cornell Community Clinic (Weill Cornell Community Clinic)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

The Weill Cornell Community Clinic (WCCC) is a student-run clinic serving the uninsured population of NYC. The WCCC has two main goals: extending healthcare access to underprivileged populations, and increasing patients' knowledge regarding their health conditions, related care, and treatment. In order to assess clinic patients' educational needs and interests, a survey was administered to all patient visits over a four-week period that requested participants to rank numerous services (e.g. smoking cessation, exercise, nutrition) with respect to interest level. Nutrition counseling was unanimously rated as being of high interest. To acknowledge and act on the recognized need voiced by WCCC patients, two methods of Nutrition Counseling have been proposed. In one solution, weekly sessions wo...

Teaching About Health Literacy: Competency-based training for medical students (Cliff Coleman MD, MPH)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

This seminar will include information about health literacy in general, including definitions, prevalence, and important health-related associations, in order to provide a common starting point for participants. We will discuss evidence-based best-practices for mitigating the effects of low health literacy. We will then discuss competency-based training outcomes, and associated methods for teaching and evaluating learners. We will discuss various curricular models, and examine the example of one medical school's health literacy curriculum in more detail. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

SIM-EHR (Simulated EHR): A Virtual Case-based Educational Tool (Fran E Biagioli MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

Slide set for the Simulated Electronic Health Record Seminar for the Medical Student Education STFM conference in Long Beach California, 2012. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Launch of a New Longitudinal Integrated Curriculum for Third-Year Medical Students: Highlighting Family Medicine's Role (Peggy R Cyr MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

Family Medicine's Role in the New Longitudinal Integrated Curriculum (LIC) for Third-Year Medical Students (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Social Work and Medical Student Collaboration in Psychosocial Assessments (Weill Cornell Community Clinic)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

-The Weill Cornell Community Clinic (WCCC) opened its doors on April 2006, and Social Work was an integral part of the clinic since its inception. Each year, a Medical Student Board Member serves as a liaison to the New York Presbyterian Hospital's Social Work Department. -Initially, Social Work Interns, supervised by a licensed Social Worker volunteered to staff the clinic weekly to conduct psychosocial assessments approximately 4 months out of the year. -Since 2010, licensed Social Workers volunteer at the clinic year-round, and Social Work Interns volunteer in their second semester from January-April. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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Longitudinal Primary Care Pharmacotherapy Elective for Medical Students (Jonell Hudson PharmD, BCPS)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

Slides presented at STFM Conference on Medical Student Education in 2012 in Long Beach, CA. Describes an elective course offered to M4s that is lead by pharmacists. The course has evolved to include learners from other disciplines. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Is Presence of a Student-Run Clinic During Medical School Associated with Future Primary Care Practice? (Sebastian Tong Mr.)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Tue, 07 Feb 2012 05:00:00 +0100

This powerpoint presentation addresses whether there is an association between presence of a student-run clinic at a medical school and future practice of medical school graduates in a primary care specialty. A 2005 survey of all student-run clinics associated with medical schools was supplemented by direct survey of schools missing from this dataset. We used multiple linear regression to test associations controlling for medical school confounders. In 2005, 72 of 115 responding medical schools had student-run clinics. No association was found between having a student-run clinic at a medical school and proportion of its graduates who currently practice primary care. We will discuss implications and future directions for student-run clinic research. Please contact me (Sebastian Tong) by em...

Multi‐professional communication for older people in transitional care: a review of the literature

International Journal of Older People Nursing — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. Specified discharge worker roles, multi‐professional care coordination teams, and information technology systems promote better service satisfaction and subjective quality of life for older people when compared with standard hospital discharge. Improved multi‐professional communication reduces rates of re‐admission and length of stay indicating greater cost effectiveness and efficiency for the health and social care systems. Systems of care emphasizing information exchange, education and negotiation between stakeholders facilitate communication in transitional care contexts for older adults. Conversely, lack of dialogue and lack of understanding of others’ roles are barriers to communication in transitional care.Relevance to clinical practice. Enhanced multi‐pr...

Bereavement care for older people in healthcare settings: qualitative study of experiences

International Journal of Older People Nursing — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. The study identified the interactions of healthcare staff with bereaved older people in terms of the bereavement journey. Staff demonstrated awareness of difficulties the bereaved person may encounter and showed commitment to providing support. However, lack of flexibility in services restricts meaningful interactions.Implications for Practice. (i) Healthcare staff may identify gaps in services in terms of preparing relatives and follow‐up post‐bereavement; (ii) Therapeutic relationships between staff and relatives enable ongoing support; (iii) Development of practice guidelines is a key consideration. (Source: International Journal of Older People Nursing)

Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study

Diabetic Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: Glucose control is inadequate among insulin‐treated patients, in part attributable to insulin omission/non‐adherence and lack of dose adjustment. There is a need for insulin regimens that are less restrictive and burdensome with lower risk of hypoglycaemia.© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK (Source: Diabetic Medicine)

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The cost of diagnosing Type 2 diabetes mellitus by clinical opportunistic screening in general practice

Diabetic Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: Almost two‐thirds of new cases of Type 2 diabetes can be detected before symptoms are reported, at reasonable cost by opportunistic screening in general practice, without the use of extra resources. As an affordable alternative to population screening, clinical opportunistic screening merits further consideration.© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK (Source: Diabetic Medicine)

Ovarian cancer screening popular despite guidelines

Reuters: Health — Mon, 06 Feb 2012 22:20:29 +0100

NEW YORK (Reuters Health) - Despite expert guidelines and scientific evidence to the contrary, a third of U.S. primary care physicians believe ovarian cancer screening is effective and many would offer it to patients, according to a new survey. (Source: Reuters: Health)

Ovarian Cancer Screening Popular Despite Guidelines

MedlinePlus Health News — Mon, 06 Feb 2012 22:20:22 +0100

Despite expert guidelines and scientific evidence to the contrary, a third of U.S. primary care physicians believe ovarian cancer screening is effective and many would offer it to patients, according to a new survey.Source: Reuters Health Related MedlinePlus Pages: Health Screening, Ovarian Cancer (Source: MedlinePlus Health News)

New primary care model in the making in New Orleans

Healthcare IT News — Mon, 06 Feb 2012 21:40:28 +0100

The Crescent City Beacon Community will get assistance to strengthen the New Orleans healthcare infrastructure and health IT to improve care coordination and population health in 18 participating practices, including community health centers. Election Feature Content: No sticky read more (Source: Healthcare IT News)

Smoking 'speeds up mental decline' in middle-aged men

HealthcareRepublic Pharmacist News — Mon, 06 Feb 2012 21:00:00 +0100

Middle-aged men who smoke will experience faster mental decline which accelerates the more they smoke, UK research suggests. (Source: HealthcareRepublic Pharmacist News)

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Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality

Osteoporosis International — Mon, 06 Feb 2012 19:37:21 +0100

Conclusions Pelvic fractures are associated with high rates of hospitalisation and mortality. Given this, further work is required to identify the optimal post-fracture therapeutic strategy to improve outcomes in this elderly patient group. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00198-012-1907-zAuthors D. Prieto-Alhambra, Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UKF. F. Avilés, Institut Català de la Salut—IDIAP Jordi Gol i Gurina, Barcelona, SpainA. Judge, Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoske...

Aldosterone in Heart Disease

Current Hypertension Reports — Mon, 06 Feb 2012 19:35:19 +0100

Abstract Numerous studies have now shown that sustained elevation of aldosterone levels induces cardiovascular damage independent from its effects on regulation of renal sodium and blood pressure. Increased aldosterone and cortisol levels in patients with heart failure independently predict the risk of mortality. Over the past decade, there has been increased interest in identifying the role of the receptor for aldosterone, the mineralocorticoid receptor (MR), following the results from the large clinical heart failure trials that showed low doses of MR antagonists reduced morbidity and mortality in heart failure and myocardial infarction, even though plasma levels of aldosterone were in the physiologic range. The mechanism for this cardioprotective action remains to be de...

Health Economics of Interdisciplinary Rehabilitation for Chronic Pain: Does it Support or Invalidate the Outcomes Research of These Programs?

Current Pain and Headache Reports — Mon, 06 Feb 2012 19:34:33 +0100

Abstract Interdisciplinary rehabilitation has been shown to be effective for treatment of patients suffering from chronic nonmalignant pain with respect to activity level, pain intensity, function, or days of sick leave. However, effects in clinical outcome do not necessarily imply a superiority of the intervention from an economic point of view. Despite an increasing number of cost-utility and cost-effectiveness studies, systematic reviews outline the methodological heterogeneity of studies, which makes it impossible to perform meta-analyses and to draw conclusions from the studies. Recent publications add interesting information to the current discussion; these studies cover the long-term development of sickness absence post-intervention and the cost effectiveness of wor...

Overweight Physicians Less Likely to Give Diet AdviceOverweight Physicians Less Likely to Give Diet Advice

Medscape Today Headlines — Mon, 06 Feb 2012 17:18:45 +0100

A doctor's weight may be a factor in diagnosing obesity, a study finds. WebMD Health News (Source: Medscape Today Headlines)

Diabetes 'increases birth defect risk'

NHS News Feed — Mon, 06 Feb 2012 17:00:00 +0100

Conclusion This study supports the existence of an association between maternal diabetes and increased risk of birth abnormalities, and helps quantify the size of the association. The study’s strengths include its large size and ability to include the entire population in the study area. However, there are a number of points to note: The researchers took into account various factors that could influence the results. However, as with all studies of this type, it is possible that unknown or unmeasured factors, other than maternal diabetes, could have affected the risk of birth defects. From this study we cannot say what effect diabetes arising in pregnancy (gestational diabetes) might have on risk of birth defects, as these women were not included in this analysis. The study relie...

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Caring for individual patients and beyond: Enhancing care through secondary use of data in a general practice setting

ICMCC: The International Council on Medical and Care Compunetics — Mon, 06 Feb 2012 16:08:07 +0100

Source: Tolar M, Balka E. International Journal of Medical Informatics, 2012 Content: It is argued that with the introduction of electronic medical record (EMR) systems into the primary care sector, data collected can be used for secondary purposes which extend beyond individual patient care (e.g., for chronic disease management, prevention and clinical performance evaluation). However, [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Target prevention to tackle cardiovascular disease burden

HealthcareRepublic Pharmacist News — Mon, 06 Feb 2012 15:30:00 +0100

Risks must be prevented from developing, rather than simply treated once they occur, to deal with the burden of cardiovascular disease (CVD), according to US researchers. (Source: HealthcareRepublic Pharmacist News)

BMA briefing paper outlines 'serious risks' of Health Bill

HealthcareRepublic Pharmacist News — Mon, 06 Feb 2012 12:05:00 +0100

Government amendments to the Health Bill do not alter the fact it is fundamentally flawed, the BMA has said in a briefing to the Lords. (Source: HealthcareRepublic Pharmacist News)

Reactive Arthritis (Reiter’s Syndrome) Mimicking Onychomycosis

Consultant Live — Mon, 06 Feb 2012 12:00:00 +0100

A 33-year-old man seeks attention for his abnormal toenails, having already failed full treatment courses of both terbinafine and itraconazole. (Source: Consultant Live)

Onychomycosis-- or Something Else?

Consultant Live — Mon, 06 Feb 2012 12:00:00 +0100

A 33-year-old man seeks attention for his abnormal toenails, having already failed full treatment courses of both terbinafine and itraconazole. Review of systems reveals complaints of painful “eye irritation” as well as chronic low back pain severe enough to warrant daily ingestion of aspirin. What diagnoses in addition to onycomycosis would you consider given this picture? (Source: Consultant Live)

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Judging Osteoporosis Screening Intervals from the Latest T Score

Consultant Live — Mon, 06 Feb 2012 12:00:00 +0100

(Source: Consultant Live)

How to Prevent Employee Embezzlement

Consultant Live — Mon, 06 Feb 2012 12:00:00 +0100

Staff handle your checks and copays. Are you sure they aren't stealing from you? Don't chance it; manage it. (Source: Consultant Live)

Hemoptysis, Hoarseness, and Dyspnea in an Older Man

Consultant Live — Mon, 06 Feb 2012 12:00:00 +0100

(Source: Consultant Live)

Poll results: See what our readers thought of last week's news

HealthcareRepublic Pharmacist News — Mon, 06 Feb 2012 10:59:00 +0100

We asked you what you thought about the withdrawal of the Health Bill, 'target culture' and NHS 111 service. (Source: HealthcareRepublic Pharmacist News)

Booze and Family History of Colon Cancer a Bad Mix: Study

MedicineNet Mens Health General — Mon, 06 Feb 2012 07:00:00 +0100

Title: Booze and Family History of Colon Cancer a Bad Mix: StudyCategory: Health NewsCreated: 2/3/2012 2:05:00 PMLast Editorial Review: 2/6/2012 (Source: MedicineNet Mens Health General)

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Multiple Sclerosis: 10 Things Primary Care Providers Need to Know Now

Consultant Live — Mon, 06 Feb 2012 06:00:01 +0100

Here: 10 tips that can help you provide optimal care of your patients with MS. (Source: Consultant Live)

Family Physicians Lead in Specialties in Providing Rural Health Care

News stories via the Rural Assistance Center — Mon, 06 Feb 2012 06:00:00 +0100

AAFP News Now article reports that family physicians provide more health care to rural areas than other primary care or subspecialty physicians, according to data released by the Agency for Healthcare Research and Quality. (Source: News stories via the Rural Assistance Center)

The Weill Cornell Community Clinic Student Advisory Committee: A Model for Maintenance and Growth ()

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

A goal of the Weill Cornell Community Clinic is to provide comprehensive health care to our patients that extends beyond primary care to include such services as mental health, women's health, pharmacy, and referrals. Key to the successful maintenance and expansion of our service offerings is the organizational structure of the Clinic, led by the Student Advisory Committee. As part of the Committee, medical students learn firsthand the challenges of managing a clinic and running a non-profit organization, along with the difficulties that underserved patients face in attaining high quality health care. Thus the Student Advisory Committee provides a unique addition to medical school education while also improving the services the Weill Cornell Community Clinic can offer our patients. (Source...

Motivational Interviewing for Weight Loss & Exercise (Frank Domino MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

Brief introduction on how to use Motivational Interviewing for weight loss and exercise for third year medical students from the Un. of Massachusetts Medical School 2011. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Obesity: the Problem (Frank Domino MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

A brief overview of the source of the US obesity epidemic as part of the UmassMed Healthy Living Curriculum (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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Counseling for Weight Loss and Exercise (Frank Domino MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

5 brief counseling steps for Medical Students to use, along with Motivational Interviewing, to help patients lose weight and exercise (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Creation, Validation, and Use of the fmCASES Family Medicine Clerkship Examination Peer Paper Presentation (Bridie Napier MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

Creation, Validation, and Use of fmCASES Family Medicine Clerkship Exam (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

The Weill Cornell Community Clinic Insurance Enrollment Program (Weill Cornell Community Clinic)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Mon, 06 Feb 2012 05:00:00 +0100

The Weill Cornell Community Clinic (WCCC) started a facilitated insurance enrollment program in 2009(?). The aim of the program is to educate patients about available free or low cost insurance options and to serve as mentors while guiding patients through the enrollment process. A group of trained medical students screens all new and follow-up patients that attend the clinic. Screening questions include employment status, monthly income, and household composition. If patients are eligible, the WCCC collaborates with health care advocates at the Lenox Hill Neighborhood House to enroll patients in public health insurance options. Over the past two years, this program has screened 125 patients. In the past 6 months, 47 patients were screened for public health insurance. Eleven (23.4%) pati...

Detours on the Road to Diagnosis of Graves Disease

Clinical Pediatrics — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions. Evaluation and treatment for presumed other disorders are common in children with GD. A high index of suspicion for hyperthyroidism by primary care providers may help to avoid clinical detours that may be costly and delay diagnosis. (Source: Clinical Pediatrics)

Comparison of Systematic Developmental Surveillance With Standardized Developmental Screening in Primary Care

Clinical Pediatrics — Mon, 06 Feb 2012 05:00:00 +0100

Many physicians use surveillance questions to assess development; the American Academy of Pediatrics recommends screening at 9-, 18-, and 24-month health supervision visits (HSVs). There are no studies directly comparing surveillance with screening. The authors directly compared systematic surveillance with standardized screening using a cross-sectional observational study of children with no known delays. Surveillance questions were completed at each HSV. The Ages and Stages Questionnaire (ASQ) was administered following the 9-, 18-, or 24-month HSV. The authors compared detection of delays by surveillance with ASQ screening. Using surveillance, 11/95 subjects were identified as delayed. Using the ASQ, 15/95 subjects scored fail; 28/95 scored monitor. Among the 11 delayed surveillance sub...

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Screening mammography beliefs and recommendations: a web-based survey of primary care physicians

BMC Health Services Research — Mon, 06 Feb 2012 05:00:00 +0100

This study explored primary care physicians' (PCPs) perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to the hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before recently revised United States Preventive Services Task Force (USPSTF) guidelines. Methods: A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684); (41%) 271 family physicians (FP), (36%) 232 general internal medicine physicians (IM), (23%) 150 obstetrician-gynaecologists (OBG), and (0.2%) 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in respon...

Social Anxiety Disorder in Genuine Halitosis PatientsSocial Anxiety Disorder in Genuine Halitosis Patients

Medscape Today Headlines — Mon, 06 Feb 2012 04:00:00 +0100

This study investigated the influence of social anxiety disorder on the level of anxiety in genuine halitosis patients before and after treatment. How well can these patients overcome their anxiety? Health and Quality of Life Outcomes (Source: Medscape Today Headlines)

Evaluation of a direct access cardiac arrhythmia monitoring service.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Conclusions: Direct access for cardiac arrhythmia monitoring seems to provide an effective mechanism for diverting inappropriate or non-essential referrals away from the cardiology clinic. (Cardiol J 2012; 19, 1: 70-75). PMID: 22298170 [PubMed - in process] (Source: Cardiology Journal)

First infection control guidance for surgery in primary care

Nursing Times Breaking News — Mon, 06 Feb 2012 00:01:00 +0100

Practice nurses assisting in minor surgical procedures in primary care settings must be able to prove they are competent in aseptic technique, according to the first ever guidance on the area. (Source: Nursing Times Breaking News)

Managing asthma in primary care through imperative outcomes

Journal of Evaluation in Clinical Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusion Over all three of the data collection periods adherence to effectively applied management of asthma guidelines proved to be below the minimum recommended clinical evaluation work‐up as set out by the Expert Panel Report 3 (EPR3) of the National Asthma Education and Prevention Program (NAEPP). Applying a greater focus on essential outcomes through different disease management documents resulted in an improved quality of managed care, but still requires dedicated and continuous education and motivation. (NWU‐0052‐08‐A5) (Source: Journal of Evaluation in Clinical Practice)

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GP cooperative and emergency department: an exploration of patient flows

Journal of Evaluation in Clinical Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusion Although most out‐of‐hours care patients present non‐urgent health problems, at the ED they are more likely to receive diagnostic tests and follow‐up contacts. This may reflect differences in patient populations between the ED and GPC or suggest opportunities for improving efficiency of planning follow‐up contacts. (Source: Journal of Evaluation in Clinical Practice)

Improving rates of herpes zoster vaccination with a clinical decision support system in a primary care practice

Journal of Evaluation in Clinical Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusion Herpes zoster vaccination rate significantly improved with implementation of a web‐based clinical decision support system. (Source: Journal of Evaluation in Clinical Practice)

Satisfaction, Motivation, and Future of Community Preceptors (Robyn Latessa MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sun, 05 Feb 2012 05:00:00 +0100

Findings from repeat of longitudinal study conducted in one state of all AHEC community-based primary care preceptors of health science students, comparing current findings with those from six years earlier, and reporting on satisfaction, motivation, incentives/rewards valued, reasons for teaching, likelihood to continue, and discussion of implications. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

GP Burnout Rates High in UK

Health News from Medical News Today — Sat, 04 Feb 2012 17:00:00 +0100

According to an investigation of GPs (general practitioners) in one region of South East England, burnout levels in UK general practice are high. The study is published in BMJ Open. The article reveals that primary care physicians (GPs, general practitioners, family doctors) who work in group practices, those who always see the same patient, and male doctors appear to be at considerably higher risk. This finding urged the researchers to reveal that "a significant group of doctors is in trouble... (Source: Health News from Medical News Today)

Medical Spanish Close to Home--An Inner-City Spanish Immersion Elective for Medical Students (Keith Nokes MD, MPH)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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Medical Student Teaching in Teaching Health Centers (Keith Nokes MD, MPH)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

C-STAHR: Reducing Discrimination in Healthcare (Brooke Thurman Medical student)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

We are C-STAHR: Community-Students Against Healthcare Racism, a group of medical students from the University of Colorado working with 2040 Partners for health and community leaders to improve health care experiences in Denver and Aurora. We are Latino, black, white, men, women, old and young. What brings us together is the desire to combat racism and improve medical care. Our vision: For students and the community to work together to better understand perceived discrimination and design a feasible intervention to better equip future physicians and community members to reduce its effects (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Using Formative Assessment in Active Learning Environments: Transitioning from Preclinical to Clinical Training (Linda Chang PharmD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

Many medical students struggle as they enter the clinical setting because they have difficulty in integrating and applying what they have learned in the preclinical classroom. In order to address this challenge, active learning activities were added to the Essentials of Patient Care course for second year medical students. This PowerPoint was presented at the 38th Annual STFM Conference on Medical Student Education and presents 1) the structure of the course that encompasses cultural competency, health policy, preventive medicine, epidemiology/evidence-based medicine, and medical ethics; 2) examples of the active learning activities; 3) the formative assessment of students' performance in these activities qualitatively and quantitatively; and 4) the use of these assessment data to improve ...

Summary of Discussion Session S5 Teaching Practice Standards MSE12 conference (Beat Steiner MD, MPH)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

Summary of discussion from Session S5 on Feb 3 2012 by about 30 medical student educators discussion standards for community teaching practices (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

From Motivational Interviewing to Systems Based Care (Carolyn Wellbery MD, PhD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Sat, 04 Feb 2012 05:00:00 +0100

From Motivational Interviewing to Systems based care: A Third-Year Clerkship Chronic Care Model Curriculum and OSCE (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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[Case Report] A lethal injection?

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

In October, 2010, a 29-year-old man initially presented to a primary care clinic with fevers, sore throat, and odynophagia, and was treated with oral phenoxymethylpenicillin 250 mg four times daily for tonsillitis. He re-presented 72 h later with persisting symptoms and fever of 38·4°C, and was administered 1 000 000 units of intramuscular procaine benzylpenicillin. 4–5 min later, he collapsed with no cardiac output, and cardiopulmonary resuscitation was commenced. Paramedic staff arrived within 20 min and monitoring showed ventricular fibrillation. (Source: LANCET)

CDC 2D Vaccine Barcoding Pilot Nearing Sign-up Deadline

AAFP Health of the Public — Fri, 03 Feb 2012 23:35:00 +0100

For family physicians who count immunizations as one of the many services they provide, the CDC is funding a two-dimensional (2D) vaccine barcoding pilot project that is scheduled to begin in August. The pilot is gearing up to begin installing scanning equipment and training participants, but there is still time to enroll. According to Erin Kennedy, D.V.M., M.P.H., a medical officer in the CDC's Immunization Services Division, "2D barcoded vaccines have a number of potential public health benefits, which include decreasing errors in recorded immunization information and improving patient safety." The sign-up period for the project, which will assess the challenges and determine best practices for documenting vaccine encounters using 2D barcodes, comes to a close in late February. (Source: ...

Lyme Disease Ticks Endemic in Northeast, Northern MidwestLyme Disease Ticks Endemic in Northeast, Northern Midwest

Medscape Today Headlines — Fri, 03 Feb 2012 22:26:35 +0100

Field researchers have generated a detailed map that they hope will guide appropriate diagnosis and more targeted treatment for patients suspected of having Lyme disease. Medscape Medical News (Source: Medscape Today Headlines)

Most GP Complaints Resolved Locally, UK

Health News from Medical News Today — Fri, 03 Feb 2012 18:00:00 +0100

According to an analysis of complaints in the latest edition of inpractice, the Medical Defense Union's journal that appears twice a year and is aimed at GP practice manager members covering topics like complaints, RCN indemnity changes and dealing with estranged parents, over 90% of 2,410 complaints made by GP members in the year April 2009/2010 seem to have been resolved locally. According to the MDU, this quota represents a great achievement made by practice managers who frequently take a lead in managing complaints... (Source: Health News from Medical News Today)

Physician Groups Say 5010 Standards Hurt Cash FlowPhysician Groups Say 5010 Standards Hurt Cash Flow

Medscape Today Headlines — Fri, 03 Feb 2012 17:55:34 +0100

The president of the Medical Group Management Association is urging HHS to postpone enforcement of the new standard for electronic claims until June 30, lest some practices shut down. Medscape Medical News (Source: Medscape Today Headlines)

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Health Highlights: Feb. 3, 2012

Primary Care News - Doctors Lounge — Fri, 03 Feb 2012 16:04:00 +0100

Komen Breast Cancer Group Restores Planned Parenthood Funding Cooked Eggs Recalled in 34 States Sibling Study Suggests Drug Addiction Is 'Hard Wired' Taco Bell Identified as Source of Salmonella Outbreak Army Bans Exercise Supplements After Soldiers' Deaths Fungicide Levels in Orange Juice Don't Pose Health Risk: FDA (Source: Primary Care News - Doctors Lounge)

England's CMO issues cold snap warning to vulnerable patients

HealthcareRepublic Pharmacist News — Fri, 03 Feb 2012 13:55:00 +0100

England's CMO has warned elderly and chronically ill patients to take precautions after the Met Office issued a severe weather warning. (Source: HealthcareRepublic Pharmacist News)

Variation in New Zealand hospital outcomes: combining hierarchical Bayesian modeling and propensity score methods for hospital performance comparisons

Health Services and Outcomes Research Methodology — Fri, 03 Feb 2012 07:19:52 +0100

Abstract Two major statistical issues confronting comparative analyses of hospital outcomes are adequacy of case-mix adjustment and proper accounting for random variation. Hierarchical modeling has been proposed to improve precision and reduce the impact of random variation but becomes difficult to implement when there are numerous case-mix factors to control. In this paper we formulate the problem of hospital performance comparisons within the framework of potential outcomes and illustrate an approach to hospital comparisons which combines multiple category propensity score methods for the control of case-mix variations with hierarchical Bayesian modeling of case-mix adjusted summaries. The approach is similar to that proposed by Huang et al. (Health Serv Res 40:253–278...

Sex and the Elderly: STD Risk Often Ignored

MedicineNet Mens Health General — Fri, 03 Feb 2012 07:00:00 +0100

Title: Sex and the Elderly: STD Risk Often IgnoredCategory: Health NewsCreated: 2/3/2012 11:00:00 AMLast Editorial Review: 2/3/2012 (Source: MedicineNet Mens Health General)

Married Men Seek Help for Stroke Sooner Than Their Wives

MedicineNet Mens Health General — Fri, 03 Feb 2012 07:00:00 +0100

Title: Married Men Seek Help for Stroke Sooner Than Their WivesCategory: Health NewsCreated: 2/2/2012 6:06:00 PMLast Editorial Review: 2/3/2012 (Source: MedicineNet Mens Health General)

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Pfizer: world's largest research‐based drug company

Prescriber — Fri, 03 Feb 2012 06:47:14 +0100

(Source: Prescriber)

National Prescribing Centre guidance on prescribing specials

Prescriber — Fri, 03 Feb 2012 06:47:13 +0100

AbstractA special is a bespoke formulation made to meet the needs of an individual patient and requires different considerations to normal licensed products. Here, Steve Chaplin outlines the NPC guidance on prescribing a special. Copyright © 2012 Wiley Interface Ltd (Source: Prescriber)

Neuromodulators for pain management in rheumatoid arthritis

Prescriber — Fri, 03 Feb 2012 06:47:12 +0100

(Source: Prescriber)

Recommended drug therapy for inflammatory bowel disease

Prescriber — Fri, 03 Feb 2012 06:47:10 +0100

AbstractInflammatory bowel disease is a chronic condition of unclear aetiology that can greatly impact on the lives of those affected. Our Drug review discusses the currently available treatments and their properties, followed by sources of further information. Copyright © 2012 Wiley Interface Ltd (Source: Prescriber)

Fingolimod: new oral treatment for relapsing‐remitting MS

Prescriber — Fri, 03 Feb 2012 06:47:09 +0100

AbstractFingolimod (Gilenya) is an oral disease‐modifying therapy licensed for relapsingremitting multiple sclerosis (RRMS) in patients with high disease activity despite treatment with an interferon beta. In our New products review, Steve Chaplin presents the clinical data relating to its efficacy and adverse events, and Drs Klaus Schmierer and Rachel Farrell discuss its place in place in the treatment of RRMS. Copyright © 2012 Wiley Interface Ltd (Source: Prescriber)

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Management of resistant Gram‐negative urinary tract infections

Prescriber — Fri, 03 Feb 2012 06:47:08 +0100

AbstractThe authors discuss current oral and intravenous treatment options in the management of multiresistant Gram‐negative urinary tract infections in the community. Copyright © 2012 Wiley Interface Ltd (Source: Prescriber)

Prescribing costs and patient safety: getting the balance right

Prescriber — Fri, 03 Feb 2012 06:47:07 +0100

(Source: Prescriber)

Agitation From Sedation in Elderly

Consultant Live — Fri, 03 Feb 2012 06:30:02 +0100

Geriatric patients can get agitated in response to sedation. How do you respond? (Source: Consultant Live)

Data Illustrate Geographic Dispersal of Family Physicians, Other Primary Care Professionals

News stories via the Rural Assistance Center — Fri, 03 Feb 2012 06:00:00 +0100

AAFP News Now article reports that family physicians are the most likely of any physician specialty or subspecialty to practice in rural areas and the most likely to be geographically distributed in the same proportion as the U.S. population, according to a one-page fact sheet published by the Agency for Healthcare Research and Quality (AHRQ). (Source: News stories via the Rural Assistance Center)

Adult Immunizations Continue to Lag

Physician's First Watch current issue — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Physician's First Watch current issue)

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Living, Breathing and Teaching the Core Values of Family Medicine (Donald Woolever MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

Core values of family medicine; definitions, committment, how to teach and how to measure (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Enhancing Students' Literature Searches by Integrating Personal Librarian Feedback into a PBL Course (Suzanne Edmunds MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

Peer presentation about a curriculum intervention for 1st year medical students in which they received electronic feedback from their "personal librarians" about search strategies related to learning issues in 6 PBL cases over a period of time. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Longitudinal Approach to Teaching PubMed Search Strategy Skills to Medical Students (Harald Lausen DO)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

(Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

fmConnect: Putting Critical Pieces Together for Successful Family Medicine Student Recruitment (Judy Gary MEd)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

Presentation given at 2012 Medical Student Education Conference (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

fmSTAT: Family Medicine Scholars Training and Admission Track (Judy Gary MEd)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

1 General information about the VCU Department of Family Medicine fmSTAT Program 2 Description of a new dual admission program at Virginia Commonwealth University School of Medicine. 3 Sample of supplemental fmSTAT application. 4 Snapshot of curricular elements, format, and benefits of the program for participants 5 A values inventory used during the interviewing day. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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Clerkship Projects as Supplemental Educational Tools (Suzanne Harrison MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 03 Feb 2012 05:00:00 +0100

National Survey of Clerkship Directors on projects included in clerkships; information includes types of projects, curricular themes, and examples as they relate to ACGME competencies. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis

BMC Family Practice — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Warfarin use has increased somewhat over time. The decision to prescribe warfarin for stroke prevention in atrial fibrillation is based upon multiple prescriber and patient characteristics. These findings can be used by family practice prescribers and other healthcare decision-makers to target interventions or methods to improve utilization of warfarin when it is indicated for stroke prevention. (Source: BMC Family Practice)

Attribution dataset GP registered populations scaled to ONS population estimates, 2011

NeLM - News — Fri, 03 Feb 2012 05:00:00 +0100

Source: NHS Information Centre Area: News This publication contains information about populations registered with GP practices at Strategic Health Authority (SHA) and Primary Care Organisation (PCO) level in five-year age bands by gender, for England and Wales. The data was collected in April 2011 for GP relevant populations. (Source: NeLM - News)

The Alabama Coalition for a Healthier Black Belt: A Proof of Concept Project.

Community Mental Health Journal — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Savage RM, Dillon JM, Hammel JC, Lewis TC, Johnson NC, Barlow LM, Brooms MM, Moore PM, Parker HE, Rodney KZ Abstract The Alabama Coalition for a Healthier Black was a demonstration of concept project. This paper is a descriptive and qualitative overview of this 2.5 year project. Limited key project results are reported here. Located in the rural Black Belt region of Alabama this coalition had several key aims: to develop a collaboration between primary care and mental health care through co-location of services; use of video-conferencing capability to provide mental health services more efficiently; enhanced training in rural healthcare; and development of stigma reduction campaigns along with other coalition partner specific initiatives. Co-location and telepsychiatry im...

PIP implants: Taking the right decision and lessons to be learnt

OnMedica Views — Fri, 03 Feb 2012 05:00:00 +0100

Fazel Fatah, president of BAAPS, discusses the controversy and highlights the guidelines for health professionalsRelated items from OnMedicaWelsh NHS to pay for PIP implant removal and replacementGovernment sets scope for cosmetic surgery reviewsAll women with defective breast implants entitled to surgical assessment and removal Latest advice on PIP implantsRegulator moves to reassure UK women after breast implant scare (Source: OnMedica Views)

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Aging America Creates Demand for Health-Care WorkersAging America Creates Demand for Health-Care Workers

Medscape Medical News Headlines — Fri, 03 Feb 2012 02:25:05 +0100

The graying of America and a booming Hispanic population is driving major changes in the structure of the U.S. workforce and the types of jobs that will be available over the next decade. Reuters Health Information (Source: Medscape Medical News Headlines)

Excessive daytime sleepiness and narcolepsy - An approach to investigation and management.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:28:21 +0100

Authors: Morrison I, Riha RL Abstract Excessive daytime sleepiness is a common presentation to physicians both in general practice and hospital settings. In this review, we provide an update on the latest theories on the pathogenesis of the condition, and discuss the approach to investigation of the sleepy patient, with particular reference to narcolepsy. Recommended therapy is reviewed for both narcolepsy and cataplexy, to provide physicians with an important reference on the investigation and management of these troubling conditions. PMID: 22284238 [PubMed - in process] (Source: European Journal of Internal Medicine)

Study Shows Why Massage Helps Exercise RecoveryStudy Shows Why Massage Helps Exercise Recovery

Medscape Today Headlines — Thu, 02 Feb 2012 19:23:08 +0100

Benefits reflect mitochondrial biogenesis, reduced inflammatory mediators, not clearing of lactic acid. Medscape Medical News (Source: Medscape Today Headlines)

Report Says Dentists Should Be Paid by OutcomesReport Says Dentists Should Be Paid by Outcomes

Medscape Today Headlines — Thu, 02 Feb 2012 18:40:00 +0100

Kellogg researchers say dental care needs a more systematic effort to improve. Medscape Medical News (Source: Medscape Today Headlines)

The Link Between the Renin-Angiotensin-Aldosterone System and Renal Injury in Obesity and the Metabolic Syndrome

Current Hypertension Reports — Thu, 02 Feb 2012 18:12:54 +0100

This article reviews the role of the RAAS in renal injury seen in obesity and the metabolic syndrome. Content Type Journal ArticleCategory Hypertension and Metabolic Disarray: Diabetes Mellitus, Insulin Resistance, and Obesity (E Reisin, Section Editor)Pages 1-10DOI 10.1007/s11906-012-0245-zAuthors Tina Thethi, Tulane University School of Medicine, 1430 Tulane Ave., #SL - 53, New Orleans, LA 70112, USAMasumi Kamiyama, Tulane University School of Medicine, 1430 Tulane Ave., #SL39/M720, New Orleans, LA 70112, USAHiroyuki Kobori, Tulane University School of Medicine, 1430 Tulane Ave., #SL39/M720, New Orleans, LA 70112, USA Journal Current Hypertension ReportsOnline ISSN 1534-3111Print ISSN 1522-6417 (Source: Current Hypertension Reports)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

European Journal of Pediatrics — Thu, 02 Feb 2012 18:12:28 +0100

In conclusion, RSV hospitalisation in moderately prematurely born infants is associated with increased health-related cost of care. Nevertheless, if RSV prophylaxis is to be cost-effective, a high risk group of moderately prematurely born infants needs to be identified. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00431-012-1673-0Authors Deena Shefali-Patel, Division of Asthma, Allergy and Lung Biology, MRC Asthma Centre for Allergic Mechanisms of Asthma, King’s College London, London, UKMireia Alcazar Paris, Division of Asthma, Allergy and Lung Biology, MRC Asthma Centre for Allergic Mechanisms of Asthma, King’s College London, London, UKFran Watson, Division of Asthma, Allergy and Lung Biology, MRC Asthma Centre for Allergic Mechanisms of Asthma...

“From Bench to Practice”, ESC Congress set for Munich this summer

European Society of Cardiology — Thu, 02 Feb 2012 16:43:01 +0100

In response to feedback from delegates, this year’s congress will kick off on Saturday with a fuller day of scientific sessions. The grand finale on Wednesday will be a two-hour highlight session in which world leading experts summarise all the new and exciting developments in basic, clinical and population sciences presented at the congress. Read more about this year's event.... Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of th...

Funding shortage blamed as Primary Care Cardiovascular Society closes

HealthcareRepublic Pharmacist News — Thu, 02 Feb 2012 15:41:00 +0100

The Primary Care Cardiovascular Society (PCCS) has been forced to close due to a shortage of funding, and other primary care groups warn they face similar pressures. (Source: HealthcareRepublic Pharmacist News)

NHS targets £89m annual savings from re-use of medicines

HealthcareRepublic Pharmacist News — Thu, 02 Feb 2012 15:30:00 +0100

Over half of patients would be happy to re-use medicines returned to the NHS provided they pass a safety check, a poll commissioned by the NHS Sustainability Unit has found. (Source: HealthcareRepublic Pharmacist News)

MedWorm: Primary Care

Index

Intrapartum Care the Midwifery Way: A Review

Postpartum Hemorrhage

Cesarean Delivery

Electronic Fetal Monitoring: Family Medicine Obstetrics

Third-Trimester Pregnancy Complications

Genetic Screening and Counseling: Family Medicine Obstetrics

Family Medicine Obstetrics: Pregnancy and Nutrition

Forthcoming Issues

Contents

Contributors

Thank you to Reviewers

Editorial Board

Billing and Collections: Best Practices

Bridging the gap

Many Doctors May Be Less Than Honest With Their Patients

The Healthy Teens Initiative: a collaborative model for improving access to highly effective contraception for adolescents

Honesty Is a Sometimes Policy for Many PhysiciansHonesty Is a Sometimes Policy for Many Physicians

Heart disease risk passes from father to son, study finds

Education program cuts antibiotic dispensing in primary care

Adherence to national guidelines for surveillance after curative resection of nonmetastatic colon and rectum cancer: a survey among Norwegian gastrointestinal surgeons

PPI Ineffective for Asthma Control in Children With No GERD Symptoms

Health Highlights: Feb. 8, 2012

Behavioral EconomicsBehavioral Economics

NICE to develop formulary rules 'to tackle drug postcode lottery'

GPs told to investigate obesity in last minute of consultation

Only Take Contracts That Pay Enough

Antihypertensive Drugs for the Elderly: Too Much of a Good Thing

Physician Wages in States with Expanded APRN Scope of Practice

BMA leaders call for Lansley to quit as Lords prepare to debate reforms

Elderly 'passed like parcels' in care system, say MPs

The impact of lung cancer on patients and carers.

Study Examines Misconceptions Of Who Picks Up Tab When Patients Walk Out

Exemestane Associated with Increased Bone Loss in Postmenopausal Women

Bread, Poultry Account for Large Part of America's Sodium Consumption

Intussusception Risk Not Elevated with Pentavalent Rotavirus Vaccine

Teaching Teachers to Teach (Frances E Biagioli MD)

Identifying the Motivators, Challenges and Faculty Development Needs for Senior Faculty in Medical Student Education (William B Shore MD)

A Model for a Free Student-Run Mental Health Clinic (Weill Cornell Community Clinic)

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

ACP to Congress: Don’t cut primary care workforce programs

Best Practice in Primary Care Pathology: Review 14Best Practice in Primary Care Pathology: Review 14

GP practices face £200k cut in GMS contract reform

NHS panel says publishing GP outcomes data can cut postcode lotteries

Generalists Need Education on HF Treatment Generalists Need Education on HF Treatment

Ovarian Cancer Screening Common Despite Lack of Proof (CME/CE)

DH reveals details of CCG share of NHS funding

BMA demands pension talks after meeting with Lansley

Prevalence of Mental Disorders and Profile of Disablement among Primary Health Care Service Users in Lagos Island

Get Happy Front Desk Staff

Appetite Loss in the Elderly

GPs urged to check leases or face bills for thousands of pounds

NHS Commissioning Board under fire for lack of primary care representation

Health Highlights: Feb. 6, 2012

Insomnia

Management and outcome of severely elevated blood pressure in primary care: A prospective observational study.

Nutrition Counseling Initiative at the Weill Cornell Community Clinic (Weill Cornell Community Clinic)

Teaching About Health Literacy: Competency-based training for medical students (Cliff Coleman MD, MPH)

SIM-EHR (Simulated EHR): A Virtual Case-based Educational Tool (Fran E Biagioli MD)

Launch of a New Longitudinal Integrated Curriculum for Third-Year Medical Students: Highlighting Family Medicine's Role (Peggy R Cyr MD)

Social Work and Medical Student Collaboration in Psychosocial Assessments (Weill Cornell Community Clinic)

Longitudinal Primary Care Pharmacotherapy Elective for Medical Students (Jonell Hudson PharmD, BCPS)

Is Presence of a Student-Run Clinic During Medical School Associated with Future Primary Care Practice? (Sebastian Tong Mr.)

Multi‐professional communication for older people in transitional care: a review of the literature

Bereavement care for older people in healthcare settings: qualitative study of experiences

Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study

The cost of diagnosing Type 2 diabetes mellitus by clinical opportunistic screening in general practice

Ovarian cancer screening popular despite guidelines

Ovarian Cancer Screening Popular Despite Guidelines

New primary care model in the making in New Orleans

Smoking 'speeds up mental decline' in middle-aged men

Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality

Aldosterone in Heart Disease

Health Economics of Interdisciplinary Rehabilitation for Chronic Pain: Does it Support or Invalidate the Outcomes Research of These Programs?

Overweight Physicians Less Likely to Give Diet AdviceOverweight Physicians Less Likely to Give Diet Advice

Diabetes 'increases birth defect risk'

Caring for individual patients and beyond: Enhancing care through secondary use of data in a general practice setting

Target prevention to tackle cardiovascular disease burden

BMA briefing paper outlines 'serious risks' of Health Bill