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https://www.readbyqxmd.com/read/28104806/reducing-unnecessary-testing-an-intervention-to-improve-resident-ordering-practices
#1
Jose Melendez-Rosado, Kristine M Thompson, Jed C Cowdell, Catalina Sanchez Alvarez, Ryan L Ung, Armando Villanueva, Kayin B Jeffers, Jaafer S Imam, Mario V Mitkov, Tasneem A Kaleem, Lewis Jacob, Nancy L Dawson
PURPOSE OF THE STUDY: To reduce the number of unnecessary laboratory tests ordered through a measurement of effects of education and cost awareness on laboratory ordering behaviour by internal medicine residents for common tests, including complete blood cell count (CBC) and renal profile (RP), and to evaluate effects of cost awareness on hospitalisation, 30-day readmission rate and mortality rate. STUDY DESIGN: 567 patients admitted during February, March and April 2014 were reviewed as the control group...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28104570/high-risk-injecting-behaviour-among-people-who-inject-pharmaceutical-opioids-in-australia
#2
Jenny Iversen, George Dertadian, Louise Geddes, Lisa Maher
BACKGROUND: Use of opioid analgesic medicines has doubled globally over the past decade, with a concomitant increase in prevalence of injection of pharmaceutical opioids (PO), including in Australia. This study investigates types of PO injected, methods used to prepare PO for injection and correlates of recent (last 6 months) PO injection among a large national sample of people who inject drugs (PWID). METHODS: The Australian NSP Survey (ANSPS), conducted annually at ∼50 NSP services across Australia, consists of a brief self-administered questionnaire and provision of a capillary dried blood spot for HIV and hepatitis C antibody testing...
January 16, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28102439/reconstruction-of-radionuclide-intakes-for-the-residents-of-east-urals-radioactive-trace-1957-2011
#3
Evgenia I Tolstykh, Lyudmila M Peremyslova, Marina O Degteva, Bruce A Napier
The East Urals Radioactive Trace (EURT) was formed after a chemical explosion in the radioactive waste-storage facility of the Mayak Production Association in 1957 (Southern Urals, Russia) and resulted in an activity dispersion of 7.4 × 10(16) Bq into the atmosphere. Internal exposure due to ingestion of radionuclides with local foodstuffs was the main factor of public exposure at the EURT. The EURT cohort, combining residents of most contaminated settlements, was formed for epidemiological study at the Urals Research Center for Radiation Medicine, Russia (URCRM)...
January 19, 2017: Radiation and Environmental Biophysics
https://www.readbyqxmd.com/read/28100274/using-medical-specialty-and-selection-criteria-clusters-to-study-specialty-selection-by-israeli-medical-students
#4
Yoram G Weiss, Rachel Yaffa Zisk-Rony, Howard Tandeter, Uriel Elchalal, Alex Avidan, Josh E Schroeder, Charles Weissman
BACKGROUND: During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues. METHODS: Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria...
January 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28099548/teledermatology-in-tijuana-mexico
#5
Megan Brown
The Health Frontiers in Tijuana (HFiT) clinic is a binational partnership between the University of California, San Diego School of Medicine (San Diego, California); the Universidad Autónoma de Baja California School of Medicine (Tijuana, Mexico); and Desayunador Salesiano Padre Chava, a community grassroots organization in Tijuana, Mexico. Health Frontiers in Tijuana provides accessible quality health care for the underserved in Tijuana's Zona Norte. This article is a narrative meant to share my clinical experience as a dermatology resident who worked with HFiT to establish teledermatology services at this clinic...
December 2016: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28099450/advanced-neonatal-medicine-in-china-a-national-baseline-database
#6
Xiang-Peng Liao, Selma Chipenda-Dansokho, Antoine Lewin, Nadia Abdelouahab, Shu-Qin Wei
Previous surveys of neonatal medicine in China have not collected comprehensive information on workforce, investment, health care practice, and disease expenditure. The goal of the present study was to develop a national database of neonatal care units and compare present outcomes data in conjunction with health care practices and costs. We summarized the above components by extracting data from the databases of the national key clinical subspecialty proposals issued by national health authority in China, as well as publicly accessible databases...
2017: PloS One
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#7
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28099046/death-notification-someone-needs-to-call-the-family
#8
Rachel Ombres, Lauren Montemorano, Daniel Becker
BACKGROUND: The death notification process can affect family grief and bereavement. It can also affect the well-being of involved physicians. There is no standardized process for making death notification phone calls. We assumed that residents are likely to be unprepared before and troubled after. OBJECTIVE: We investigated current death notification practices to develop an evidence-based template for standardizing this process. DESIGN: We used results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28095816/awareness-and-knowledge-among-internal-medicine-house-staff-for-dose-adjustment-of-commonly-used-medications-in-patients-with-ckd
#9
Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein
BACKGROUND: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. METHODS: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28093833/cracking-the-code-residents-interpretations-of-written-assessment-comments
#10
Shiphra Ginsburg, Cees Pm van der Vleuten, Kevin W Eva, Lorelei Lingard
CONTEXT: Interest is growing in the use of qualitative data for assessment. Written comments on residents' in-training evaluation reports (ITERs) can be reliably rank-ordered by faculty attendings, who are adept at interpreting these narratives. However, if residents do not interpret assessment comments in the same way, a valuable educational opportunity may be lost. OBJECTIVES: Our purpose was to explore residents' interpretations of written assessment comments using mixed methods...
January 16, 2017: Medical Education
https://www.readbyqxmd.com/read/28093372/does-trainee-involvement-in-fluoroscopic-injections-affect-fluoroscopic-time-immediate-pain-reduction-and-complication-rate
#11
Daniel Cushman, Masaru Teramoto, Bradley Curtis, David T Lee, Austin Marcolina, Zachary McCormick
BACKGROUND: Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature examines the effect of trainee involvement on patient outcomes. OBJECTIVE: We aimed to evaluate the effect of trainee involvement on patient complications, immediate pain reduction, and fluoroscopic time for different fluoroscopic injection types. DESIGN: Retrospective review. SETTING: Four academic outpatient institutions with ACGME-accredited residency (PM&R or Anesthesiology) or fellowship (Sports Medicine or Pain Medicine) programs from 2000-2015...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28092429/residents-understanding-of-adult-congenital-heart-disease
#12
Paul Cooper, Morgan Hindes, Timothy M Maul, Stephen C Cook
OBJECTIVE: Medical residents are exposed to increasing numbers of adults with congenital heart disease (ACHD). While inadequate ACHD knowledge may lead to inappropriate practice, this educational deficit has not been investigated. Our aim was to analyze residents' attitudes, perceived ability, and knowledge of ACHD medicine. DESIGN, METHODS, OUTCOME MEASURES: A single center, multiprogram cross-sectional study was conducted in 2015 using an electronic survey to assess 472 medical residents' perceived knowledge and self-assessed skills related to ACHD medicine...
January 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28089310/take-the-heat-a-pilot-study-on-improving-communication-with-angry-families
#13
Nicolas Delacruz, Suzanne Reed, Ansley Splinter, Amy Brown, Stacy Flowers, Nicole Verbeck, Debbie Turpening, John D Mahan
OBJECTIVE: Our objective was to evaluate the utility of an educational program consisting of a workshop based on the Take the HEAT communication strategy, designed specifically for addressing patients who are angry, using a novel tool to evaluate residents' skills in employing this method. METHODS: 33 first-year pediatric and internal medicine-pediatrics residents participated in the study. The workshop presented the Take the HEAT (Hear, Empathize, Apologize, Take action) strategy of communication...
December 19, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28088497/offering-the-full-range-of-contraceptive-options-a-survey-of-interest-in-vasectomy-training-in-the-us-family-planning-community
#14
Brian T Nguyen, Andrea L Jochim, Grace H Shih
OBJECTIVE: To assess current practices regarding female and male sterilization counseling and provision, as well as determine interest in providing vasectomy among family planning specialists. METHODS: Members of the US-based network of family planning fellowship physicians (current fellows, graduates and faculty) received a Web-based survey from November 2015 through January 2016 regarding current sterilization preferences and practices, as well as interest in obtaining training in vasectomy counseling and procedure...
January 11, 2017: Contraception
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#15
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#16
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28079727/how-supervisor-experience-influences-trust-supervision-and-trainee-learning-a-qualitative-study
#17
Leslie Sheu, Jennifer R Kogan, Karen E Hauer
PURPOSE: Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. METHOD: In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28078778/texting-preferences-in-a-paediatric-residency
#18
Lauren Draper, Cadence Kuklinski, Amy Ladley, Greg Adamson, Matthew Broom
PURPOSE: Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. METHODS: A prospective study with paediatrics and internal medicine-paediatrics residents...
January 12, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28078659/summer-research-training-provides-effective-tools-for-underrepresented-minorities-to-obtain-doctoral-level-degrees
#19
Oluwatoyin A Asojo, Ashish Damania, Teri L Turner, Gayle Slaughter, Kendal D Hirschi
The ethnic, racial, and cultural diversity of the USA is not reflected in its healthcare and biomedical workforce. Undergraduate research programs are used to encourage underrepresented minorities to pursue training for biomedical careers, but there is limited published data on doctoral degree completion rates by participants in these programs. This study evaluates the attainment of doctoral degrees by a NIH-funded cohort of undergraduates from the 1998-2002 Baylor College of Medicine's Summer Medical Research Training (SMART) program...
January 11, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28078423/-sexual-medicine-in-daily-practice-germany-wide-questionnaire-of-urologists
#20
I Schloegl, F-M Koehn, K M Beier, H A G Bosinski, A Dinkel, J E Gschwend, K Herkommer
BACKGROUND: Sexual-related problems are very prevalent. Physicians of different disciplines are frequently contacted by men with those problems. OBJECTIVES: The aim of this study was to investigate the situation of sexual medicine in daily practice and to evaluate German urologists' need for further training in this field with a focus on gender-specific differences. MATERIALS AND METHODS: A five-page questionnaire included questions about sexual medicine in daily practice...
January 11, 2017: Der Urologe. Ausg. A
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