Nosocomial bloodstream infections (BSIs) are important causes of morbidity and mortality in the United States.Data from a nationwide, concurrent surveillance study (Surveillance Control Pathogens Epidemiological Importance [SCOPE]) were used to examine secular trends epidemiology microbiology nosocomial BSIs.Our detected 24,179 cases BSI 49 US hospitals over 7-year period March 1995 through September 2002 (60 per 10,000 hospital admissions). Eighty-seven percent BSIs monomicrobial....

We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between emergency settings, where most previous studies have been performed.59 GPs western Switzerland recorded all consecutive cases presenting with pain. Clinical characteristics, laboratory tests other investigations as well diagnoses remaining after 12 months follow-up were systematically registered.Among 24,620 patients examined during a total duration 300 weeks observation, 672 (2.7%)...

<sec xmlns="http://www.ncbi.nlm.nih.gov/JATS1"> <title>Aim</title> It is increasingly important for mental healthcare providers and researchers to reliably assess client change, particularly with common presenting problems such as anxiety. The current study addresses this need by establishing a Reliable Change Index of 6 points the GAD-7. </sec> <title>Method</title> Sample size included 116 online community participants using Amazon’s Mechanical Turk (MTurk) archival data 332 clinical...

Mental disorders in primary care patients are frequently associated with physical complaints that can mask the disorder. There is insufficient knowledge concerning role of anxiety, depression, and somatoform presenting symptoms. Our objective was to determine prevalence among a complaint. We also investigated relationship between cumulated psychosocial stressors mental disorders.We conducted multicentre cross-sectional study twenty-one private practices one academic centre Western...

Advances in biopsychosocial science have underlined the importance of taking social history and life course perspective into consideration primary care. For both clinical research purposes, this study aims to develop validate a standardised instrument measuring material deprivation at an individual level.We identified relevant potential questions regarding using systematic review, structured interviews, focus group interviews think-aloud approach. Item response theory analysis was then used...

In many countries, the number of graduating medical students pursuing a primary care career does not meet demand. These countries face physician shortages. Students' choices have been widely studied, yet aspects this process remain unclear. Conceptual models are useful to plan research and educational interventions in such complex systems.The authors developed framework choice undergraduate education, which expands on previously published models. They used group-based, iterative approach...

Background Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating conditions into clinical decision-making allows address mismatches between patients' health-care needs financial resources. Objectives Identify a screening question to, indirectly, rule out risk of forgoing health care economic reasons, estimate prevalence the influence physicians' attitudes toward deprivation. Design Multicenter...

Abstract Background Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify disease in emergency settings, but not primary care. Methods Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one 59 family practitioners' offices. Using delayed diagnosis we derived prediction rule out by means logistic regression model. Known cardiovascular risk...

Evidence regarding the effectiveness of oral vitamin B12 in patients with serum levels between 125-200 pM/l is lacking. We compared one-month supplementation a subtle deficiency to that placebo. This multicentre (13 general practices, two nursing homes, and one primary care center western Switzerland), parallel, randomised, controlled, closed-label, observer-blind trial included 50 who were randomized receive either (1000 μg daily, N = 26) or placebo (N 24) for four weeks. The institution's...

Switzerland is facing an impending primary care workforce crisis since almost half of all physicians are expected to retire in the next decade. Only a minority medical students choose specialty, further deepening shortage. It therefore essential identify ways promote choice career. The aim present study was explore students' views about undergraduate teaching curriculum and different formats, evaluate possible impact these on perceptions care. We surveyed fifth year from Medical Faculties...

Objective To identify which physician and patient characteristics are associated with physicians' estimation of their social status. Design Cross-sectional multicentric survey. Setting Fourty-seven primary care private offices in Western Switzerland. Participants Random sample 2030 patients ≥16, who encountered a general practitioner (GP) between September 2010 February 2011. Main measures Primary outcome: status perceived by GPs, using the MacArthur Scale Subjective Social Status, ranging...

Background Several countries have launched health information technology (HIT) systems for shared electronic medication plans. These enable patients and care professionals to use manage a common list of current medications across sectors settings. Shared plans great potential improve management patient safety, but their integration into complex medication-related processes has proven difficult, there is little scientific evidence guide implementation. Objective The objective this paper...

Abstract Background Major depression, although frequent in primary care, is commonly hidden behind multiple physical complaints that are often the first and only reason for patient consultation. depression can be screened by two validated questions easier to use care than full Diagnostic Statistical Manual of Mental Disorders , fourth edition (DSM-IV) criteria. A third question, called 'help' improves specificity without apparently decreasing sensitivity this screening procedure. We...

Chest wall syndrome (CWS), the main cause of chest pain in primary care practice, is most often an exclusion diagnosis. We developed and evaluated a clinical prediction rule for CWS. Data from multicenter cohort consecutive patients with were used (59 general practitioners, 672 patients). A final diagnosis was determined after 12 months follow-up. literature bivariate analyses to identify candidate predictors, multivariate logistic regression develop data German (n = 1212) external...

Mental disorders, common in primary care, are often associated with physical complaints. While exposure to psychosocial stressors and development or presence of principal mental disorders (i.e. depression, anxiety somatoform defined as multisomatoforme disorders) is commonly correlated, temporal association remains unproven. The study explores the onset such after a cohort care patients at least one symptom.The SODA (SOmatization, Depression Anxiety) was conducted by 21 private-practice GPs...

There is increasing evidence that a strong primary care cornerstone of an efficient health system. But Switzerland facing shortage physicians (PCPs). This pushed the Federal Council to introduce multifaceted political programme strengthen position care, including its academic role. The aim this paper provide comprehensive overview situation at five Swiss universities by end year 2012. Although teaching activities have long tradition with starting in beginning 1980ies; institutes were only...

Abstract Background The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted quantify the importance of general practitioners' (GPs) ability correctly appraise origin chest pain within first minutes encounter. Methods validation was nested multicentre cohort with one year follow-up and included 626 successive patients who presented were attended by 58 GPs Western Switzerland. assessed prior patient's history...

Inappropriate use of acute hospital beds is a major topic in health politics. We present here new approach to measure unnecessary hospitalizations Medicine and Pediatrics.The necessity admission was determined using explicit criteria related the recorded diagnoses. Two indicators (i.e. "unjustified" "sometimes justified" stays) were applied more than 800,000 stays random sample 200 them analyzed by two clinicians, routine data available medical statistics. The validation focused on their...

In this paper probabilistic methods are applied to a 1D flow model of the Secondary Air System (SAS) an industrial gas turbine. An overview and results which can be provided by analysis is given. The especially deals with problems that arise from high number input parameters connected simulation System. To overcome these fast method for detection nonlinear dependencies introduced. For improvement in development process numerical test plan SAS used calculate response surfaces describing...

Clinicians may have to adapt their online marketing and engagement strategies convey messages regarding COVID-19 telehealth appointments for current potential clients. This study reports the results of a linguistic inquiry ways therapists presented services, advertised on professional websites in six cities United States, during global pandemic. Results analysis indicated that while MFTs use positive emotional tone language, authenticity scores were poor. Dimensions Clout analytical language...