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Designed for today's busy practitioner, Taylor's Manual of Family Medicine, 4th Edition , provides practical, expert guidance for the issues you face daily in family practice and primary care. Easy to understand and clinically useful, this trusted manual has been thoroughly updated with the latest clinical information and evidence, including electronic resources. Whether you're a physician in a clinic, extended care, or hospital setting, or a resident or practitioner looking for a high-yield board review tool, this manual addresses the real-world issues you see most, allowing you to provide optimum care for every patient.Stay up to date with all-new chapters and expanded chapters on delirium, movement disorders, dementia, pregnancy loss and stillbirth, acute musculoskeletal injuries, and more.Get the latest practical information on commonly encountered clinical problems, including OB/GYN and childbirth, pediatrics, and mental health.Find what you need quickly with templated chapters that cover diagnostic criteria, clinical presentation, differential diagnosis, and screening, including physical diagnosis, laboratory findings, and imaging studies.Understand how to make the right diagnosis and know when to order the right test, based on common presenting symptoms.Use this manual to study efficiently and effectively for the ABFP certification and recertification exams. Topics follow ACGME and AAFP program requirements for residency training.Now with the print edition, enjoy the bundled interactive eBook edition, offering tablet, smartphone, or online access to:Complete content with enhanced navigationPowerful search tools and smart navigation cross-links that pull results from content in the book, your notes, and even the webCross-linked pages, references, and more for easy navigationHighlighting tool for easier reference of key content throughout the textAbility to take and share notes with friends and colleaguesQuick reference tabbing to save your favorite content for future use

The second edition of Family Practice Guidelines is a comprehensive resource for clinicians, presenting current national standard of care guidelines for practice, in addition to select 2011 guidelines. This clinical reference features detailed physical examination and diagnostic testing, information on health promotion, guidelines of care, dietary information, national resources for patient use, and patient education handouts all in one resource. This revised edition features guidelines for 246 disorders, each containing clearly outlined considerations for pediatric, pregnant, and geriatric patients. It also presents 18 procedures commonly performed in the clinical setting, including bedside cystometry, hernia reduction, neurological examination, and more. Patient Teaching Guides are also provided, and are designed to be given directly to patients as take home teaching supplements. Additionally, the book contains four appendices with guidelines on normal lab values, procedures, sexual maturity stages, and teeth.

“Engagement” with digital behaviour change interventions (DBCIs) is considered important for their effectiveness. Evaluating engagement is therefore a priority; however, a shared understanding of how to usefully conceptualise engagement is lacking. This review aimed to synthesise literature on engagement to identify key conceptualisations and to develop an integrative conceptual framework involving potential direct and indirect influences on engagement and relationships between engagement and intervention effectiveness. Four electronic databases (Ovid MEDLINE, PsycINFO, ISI Web of Knowledge, ScienceDirect) were searched in November 2015. We identified 117 articles that met the inclusion criteria: studies employing experimental or non-experimental designs with adult participants explicitly or implicitly referring to engagement with DBCIs, digital games or technology. Data were synthesised using principles from critical interpretive synthesis. Engagement with DBCIs is conceptualised in terms of both experiential and behavioural aspects. A conceptual framework is proposed in which engagement with a DBCI is influenced by the DBCI itself (content and delivery), the context (the setting in which the DBCI is used and the population using it) and the behaviour that the DBCI is targeting. The context and “mechanisms of action” may moderate the influence of the DBCI on engagement. Engagement, in turn, moderates the influence of the DBCI on those mechanisms of action. In the research literature, engagement with DBCIs has been conceptualised in terms of both experience and behaviour and sits within a complex system involving the DBCI, the context of use, the mechanisms of action of the DBCI and the target behaviour.

Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

Research in health communication frequently views it as an information dissemination strategy, thus neglecting the intricacies involved in communicating a sensitive topic such as menstruation. The social patterning in menstrual communication, a taboo in India, and its consequent health-effects on adolescents are under-studied. We studied the social determinants of menstrual communication influencing menstrual- health through semi-structured interviews of 21 boys and girls each, 12 key-respondent interviews, followed by a cross-sectional survey of 1421 adolescents from Nashik district, India. We thematically analysed the qualitative data and fit multivariable logistic regression to model risk ratios. We found social disparities in adolescents' experiences of communication taboo regarding menstruation. While boys curbed their curiosity about the topic, girls too faced resistance to their experience-sharing and treatment-seeking for menstrual illnesses. The inequality in menstruation-related communication was evident as more boys than girls faced avoidance to their questions [IRR at 95%CI: 2.75 (2.04, 3.71)]], and fewer tribal than rural girls were communicated severe taboos (OR at 95% CI: 0.18 (0.09, 0.36))]. Girls who had been communicated severe (versus no/mild) taboos reported greater stress about menstrual staining (IRR at 95% CI: 1.31 (1.10, 1.57)], emphasizing the health consequences of such communication inequalities. Our study highlights the need to address gender and setting-specific communication experiences of adolescents in India, a patriarchal society. The inequality in communication needs attention as it creates unequal patterns in Indian adolescents' menstrual health and experiences, which may manifest as inequities in reproductive health-related outcomes even in their adult-lives.

In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers' experience of caring for their late preterm infants in the community. Eleven mothers were interviewed using a semi-structured interview guide. Interview transcripts were analysed using an interpretive thematic approach. The mothers' hospital experience informed their perspective that being a late preterm infant was not a \"big deal,\" and they tended to treat their infant as normal. \"Feeding was really problem,\" especially the variability in feeding effectiveness, which was not anticipated. Failing to recognize late preterm infants' feeding distress exemplified lack of knowledge of feeding cues and tendencies to either rationalize or minimize feeding concerns. Public health nurses represent a source of informational support for managing neonatal morbidities associated with being late preterm; however, maternal experiences with public health nurses varied. Some nurses used a directive style that overwhelmed certain mothers. Seeing multiple public health nurses and care providers was not always effective, given inconsistent and contradictory guidance to care. These new and changing situations increased maternal anxiety and stress and influenced maternal confidence in care. Fathers, family, and friends were important sources of emotional support. After discharge, mothers report their lack of preparation to meet the special needs of their late preterm infants. Current approaches to community-based care can threaten maternal confidence in care. New models and pathways of care for late preterm infants and their families need to be responsive to the spectrum of feeding issues encountered, limit duplication of services, and ensure consistent and effective care that parents will accept.

Family-centered care is one the most important indicators of high-quality care. The organizational citizenship behavior and commitment can enhance the quality of healthcare. This study aimed to investigate the effect of the organizational citizenship behavior on family-centered care considering the mediating role of multiple commitment. This descriptive study was conducted on 237 nurses working in pediatric and infant units of hospitals in Tehran city, Iran. The subjects were selected using the convenience sampling method. Data collection was performed using the Organizational Citizenship Behavior Scale, Perceived Family-Centered Care Staff Questionnaire, Affective Commitment Scale, and Commitment to the Supervisor Scale. The SPSS v.22 and SEM-PLS v.2 software were used for data analysis. Results were extracted in the form of a standard model and fitted for indices pertaining to the measurement and structural models. Accordingly, the organizational citizenship behavior had a direct effect on family-centered care (β = 0.19, t = 2.39). Moreover, multiple commitment including commitment to the leader and commitment to the organization had indirect weak and moderate effects on the relationship between the organizational citizenship behavior and family-centered care, respectively. An inverse association was reported between commitment to the leader and family-centered care. Furthermore, the organizational citizenship behavior predicted family-centered care by 70% considering the mediating role of multiple commitment. Therefore, family-centered care as an indicator of high-quality care can be improved through enhancing the organizational citizenship behavior and organizational commitment among Iranian nurses working in pediatric wards.

Background Clinical practice guidelines (CPGs) have become increasingly popular, and the methodology to develop guidelines has evolved enormously. However, little attention has been given to the updating process, in contrast to the appraisal of the available literature. We conducted an international survey to identify current practices in CPG updating and explored the need to standardize and improve the methods. Methods We developed a questionnaire (28 items) based on a review of the existing literature about guideline updating and expert comments. We carried out the survey between March and July 2009, and it was sent by email to 106 institutions: 69 members of the Guidelines International Network who declared that they developed CPGs; 30 institutions included in the U.S. National Guideline Clearinghouse database that published more than 20 CPGs; and 7 institutions selected by an expert committee. Results Forty-four institutions answered the questionnaire (42% response rate). In the final analysis, 39 completed questionnaires were included. Thirty-six institutions (92%) reported that they update their guidelines. Thirty-one institutions (86%) have a formal procedure for updating their guidelines, and 19 (53%) have a formal procedure for deciding when a guideline becomes out of date. Institutions describe the process as moderately rigorous (36%) or acknowledge that it could certainly be more rigorous (36%). Twenty-two institutions (61%) alert guideline users on their website when a guideline is older than three to five years or when there is a risk of being outdated. Twenty-five institutions (64%) support the concept of \"living guidelines,\" which are continuously monitored and updated. Eighteen institutions (46%) have plans to design a protocol to improve their guideline-updating process, and 21 (54%) are willing to share resources with other organizations. Conclusions Our study is the first to describe the process of updating CPGs among prominent guideline institutions across the world, providing a comprehensive picture of guideline updating. There is an urgent need to develop rigorous international standards for this process and to minimize duplication of effort internationally.