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https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#1
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27905926/understanding-clinical-and-non-clinical-decisions-under-uncertainty-a-scenario-based-survey
#2
Vlad V Simianu, Margaret A Grounds, Susan L Joslyn, Jared E LeClerc, Anne P Ehlers, Nidhi Agrawal, Rafael Alfonso-Cristancho, Abraham D Flaxman, David R Flum
BACKGROUND: Prospect theory suggests that when faced with an uncertain outcome, people display loss aversion by preferring to risk a greater loss rather than incurring certain, lesser cost. Providing probability information improves decision making towards the economically optimal choice in these situations. Clinicians frequently make decisions when the outcome is uncertain, and loss aversion may influence choices. This study explores the extent to which prospect theory, loss aversion, and probability information in a non-clinical domain explains clinical decision making under uncertainty...
December 1, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27905281/identification-of-acanthamoeba-genotypes-in-pools-and-stagnant-water-in-ponds-in-sistan-region-in-southeast-iran
#3
Ali Aghajani, Mansour Dabirzadeh, Yahya Maroufi, Hossein Hooshyar
OBJECTIVE: Acanthamoeba is one of the most abundant free-living amoebas that is widely distributed in natural and artificial environment resources. Acanthamoeba pathogenic genotypes cause chronic human diseases including amoebic keratitis and granulomatous amoebic encephalitis. The aim of this study was to determine and identify Acanthamoeba genotypes residing in pools and stagnant water in ponds in Sistan region in southeast Iran. This descriptive study was conducted at the Parasitology Laboratory, School of Medicine, Zabol University of Medical Sciences...
September 2016: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#4
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#5
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27903252/shifting-tides-in-the-emigration-patterns-of-canadian-physicians-to-the-united-states-a-cross-sectional-secondary-data-analysis
#6
Thomas R Freeman, Stephen Petterson, Sean Finnegan, Andrew Bazemore
BACKGROUND: The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a 'brain drain' and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources...
December 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27900877/mesenchymal-stem-cells-a-promising-tool-for-targeted-gene-therapy-of-endometriosis
#7
Aghila Rani Koippallil Gopalakrishnan, Uday Kishore, Taruna Madan
Endometriosis is a leading, benign gynecological disorder around the world. Last few years have witnessed tremendous growth in the field of endometriosis and endometrial stem-cell research. Despite advancements in the biology and pathology of endometriosis, disease recurrence is still an enigma. Gene therapy holds promise in treating many pathologic conditions including endometriosis. Mesenchymal stem cells (MSCs) serve as ideal candidates for regenerative medicine and cell-based therapies. Owing to their specificity to the endometrium, residing endometrial MSC populations could be utilized as ideal candidates for targeting endometrial disorders...
November 30, 2016: Regenerative Medicine
https://www.readbyqxmd.com/read/27897470/faculty-development-efforts-to-promote-screening-brief-intervention-and-referral-to-treatment-sbirt-in-an-internal-medicine-faculty-resident-practice
#8
Alanna Stone, Maria Wamsley, Patricia O'Sullivan, Jason Satterfield, Derek D Satre, Katherine Julian
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27896692/teaching-structure-a-qualitative-evaluation-of-a-structural-competency-training-for-resident-physicians
#9
Joshua Neff, Kelly R Knight, Shannon Satterwhite, Nick Nelson, Jenifer Matthews, Seth M Holmes
BACKGROUND: The influence of societal inequities on health has long been established, but such content has been incorporated unevenly into medical education and clinical training. Structural competency calls for medical education to highlight the important influence of social, political, and economic factors on health outcomes. AIM: This article describes the development, implementation, and evaluation of a structural competency training for medical residents. SETTING: A California family medicine residency program serving a patient population predominantly (88 %) with income below 200 % of the federal poverty level...
November 28, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27896691/a-pilot-study-of-the-chronology-of-present-illness-restructuring-the-hpi-to-improve-physician-cognition-and-communication
#10
Laura M Mazer, Tina Storage, Sylvia Bereknyei, Jeffrey Chi, Kelley Skeff
BACKGROUND: Patient history-taking is an essential clinical skill, with effects on diagnostic reasoning, patient-physician relationships, and more. We evaluated the impact of using a structured, timeline-based format, the Chronology of Present Illness (CPI), to guide the initial patient interaction. OBJECTIVE: To determine the feasibility and impact of the CPI on the patient interview, written notes, and communication with other providers. DESIGN: Internal medicine residents used the CPI during a 2-week night-float rotation...
November 28, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27896145/interprofessional-multiple-step-simulation-course-improves-pediatric-resident-and-nursing-staff-management-of-pediatric-patients-with-diabetic-ketoacidosis
#11
Linnea M Larson-Williams, Amber Q Youngblood, Dawn Taylor Peterson, J Lynn Zinkan, Marjorie L White, Hussein Abdul-Latif, Leen Matalka, Stephen N Epps, Nancy M Tofil
AIM: To investigate the use of a multidisciplinary, longitudinal simulation to educate pediatric residents and nurses on management of pediatric diabetic ketoacidosis. METHODS: A multidisciplinary, multiple step simulation course was developed by faculty and staff using a modified Delphi method from the Pediatric Simulation Center and pediatric endocrinology department. Effectiveness of the simulation for the residents was measured with a pre- and post-test and a reference group not exposed to simulation...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27894226/adaptation-of-oral-medication-in-people-institutionalized-in-nursing-homes-for-whom-medication-is-crushed-the-adecua-study
#12
Francisco Apolo Carvajal, María González Martínez, Elena Capilla Santamaría, Betsabé Cáliz Hernández, Icíar Cañamares Orbis, Nuria Martínez Casanova, Eugenia Martínez Sánchez, Ainhoa Aranguren Oyarzábal, María José Calvo Alcántara, Encarnación Cruz Martos
PURPOSE: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. METHODS: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27893952/acceptability-and-impact-of-a-required-palliative-care-rotation-with-prerotation-and-postrotation-observed-simulated-clinical-experience-during-internal-medicine-residency-training-on-primary-palliative-communication-skills
#13
Maxwell T Vergo, Sharona Sachs, Meredith A MacMartin, Kathryn B Kirkland, Amelia M Cullinan, Lisa A Stephens
BACKGROUND: Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. OBJECTIVE: To assess skills acquisition and acceptability for IM residents not selecting an elective. DESIGN: A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#14
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27890870/improving-the-quality-of-postgraduate-education-in-traditional-japanese-kampo-medicine-for-junior-residents-an-exploratory-survey-conducted-in-five-institutions-in-the-tohoku-area
#15
Shin Takayama, Seiichi Kobayashi, Soichiro Kaneko, Masao Tabata, Shinya Sato, Keiichi Ishikawa, Saya Suzuki, Ryutaro Arita, Natsumi Saito, Tetsuharu Kamiya, Hitoshi Nishikawa, Yuka Ikeno, Junichi Tanaka, Minoru Ohsawa, Akiko Kikuchi, Takehiro Numata, Hitoshi Kuroda, Michiaki Abe, Satoru Ishibashi, Nobuo Yaegashi, Tadashi Ishii
Traditional Japanese (Kampo) medicine has been widely applied in general medicine in Japan. In 2001, the model core curriculum for Japanese medical education was revised to include Kampo medicine. Since 2007, all 80 Japanese medical schools have incorporated it within their programs. However, postgraduate training or instruction of Kampo medicine has not been recognized as a goal for the clinical training of junior residents by Japan's Ministry of Health, Labour and Welfare; little is known about postgraduate Kampo medicine education...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27890811/enteric-fever-in-barcelona-changing-patterns-of-importation-and-antibiotic-resistance
#16
Ana Requena-Méndez, Monica Berrocal, Manuel Almela, Alex Soriano, Joaquim Gascón, José Muñoz
BACKGROUND: Enteric fever's incidence is decreasing among residents of high-income countries, although it's rising in travelers coming from low-resource endemic settings. The study's aim is to describe epidemiological, clinical and laboratory features of patients with enteric fever. METHODS: Retrospective descriptive study of enteric fever cases diagnosed at a Tropical Medicine Unit in Barcelona, 1993-2012. RESULTS: Out of 40 patients, 31(77,5%) were returning travelers, and 70% of them had been in Southern Asia...
November 24, 2016: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/27888177/study-protocol-for-a-cluster-randomised-controlled-trial-of-an-ncd-access-to-medicines-initiative-evaluation-of-novartis-access-in-kenya
#17
Peter C Rockers, Veronika J Wirtz, Taryn Vian, Monica A Onyango, Paul G Ashigbie, Richard Laing
INTRODUCTION: Novartis recently launched Novartis Access, an initiative to provide a basket of reduced price medicines for non-communicable diseases (NCDs) to be sold through the public and private non-profit sectors in programme countries. This study will evaluate the impact of Novartis Access on the availability and price of NCD medicines at health facilities and households in Kenya, the first country to receive the programme. METHODS AND ANALYSIS: This study will be a cluster-randomised controlled trial...
November 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/27887795/clinician-knowledge-clinician-barriers-and-perceived-parental-barriers-regarding-human-papillomavirus-vaccination-association-with-initiation-and-completion-rates
#18
Lila J Finney Rutten, Jennifer L St Sauver, Timothy J Beebe, Patrick M Wilson, Debra J Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T Vadaparampil, Robert M Jacobson
PURPOSE: We tested the hypothesis that clinician knowledge, clinician barriers, and perceived parental barriers relevant to the human papillomavirus (HPV) vaccination account for the variation in vaccine delivery at the practice-site level. METHODS: We conducted a survey from October 2015 through January 2016 among primary care clinicians (n=280) in a 27-county geographic region to assess clinician knowledge, clinician barriers, and perceived parental barriers regarding HPV vaccination...
November 23, 2016: Vaccine
https://www.readbyqxmd.com/read/27885240/incidence-and-characteristics-of-needlestick-injuries-among-medical-trainees-at-a-community-teaching-hospital-a-cross-sectional-study
#19
Ben Ouyang, Lucy Dx Li, Joanne Mount, Alainna J Jamal, Lauren Berry, Carmine Simone, Marcus Law, R W Melissa Tai
ObjectivesThis field study aimed to determine the incidence and distribution of needlestick injuries among medical trainees at a community teaching hospital in Toronto, Canada.MethodsThe study was performed during the 2013-2015 academic years at Toronto East General Hospital (TEGH), a University of Toronto-affiliated community-teaching hospital during the 2013-2015 academic years. Eight-hundred and forty trainees, including medical students, residents, and post-graduate fellows, were identified and invited via email to participate in an anonymous online fluidsurveys...
November 22, 2016: Journal of Occupational Health
https://www.readbyqxmd.com/read/27885003/circadian-clocks-not-your-grandfather-s-clock
#20
REVIEW
Fred W Turek
The last 20 years have seen the rapid evolution of our understanding of the molecular genes and networks that enable almost all forms of life to generate 24-hour-or circadian-rhythms. One finding has been particularly exciting: that the molecular circadian clock resides in almost all of the cells of the body and that the clock regulates the timing of many cellular and signaling pathways associated with multiple disease states. Such advances represent a new frontier for medicine: circadian medicine.
November 25, 2016: Science
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