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Rachel A Hoopsick, D Lynn Homish, Paul T Bartone, Gregory G Homish
Background: Much research has focused on stress related to deployments; however, a substantial proportion of soldiers never deploy. In a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed. Thus, not being deployed may have an impact on soldiers' well-being; however, no measures exist to assess emotions regarding non-deployment. We aimed to develop and test an original measure of non-deployment emotions. Methods: We examined the Non-Deployment Emotions (NDE) questionnaire, a novel four-item measure of guilt, unit value, unit camaraderie, and unit connectedness in a sample of never-deployed male and female US Army Reserve/National Guard (USAR/NG) soldiers (N = 174)...
March 14, 2018: Military Medicine
Alison Brown, Helen Dickinson, Margaret Kelaher
Recent research has advanced understanding of corporate governance of healthcare quality, highlighting the need for future empirical work to develop beyond a focus on board composition to a more detailed exploration of the internal workings of governance that influence board engagement and activities. This paper proposes a conceptual framework to guide empirical research examining the work of board and senior management in governing healthcare quality. To generate this framework, existing conceptual approaches and key constructs influencing effectiveness are identified in the governance literature...
February 24, 2018: Social Science & Medicine
Furman S McDonald, Lauren M Duhigg, Gerald K Arnold, Ruth M Hafer, Rebecca S Lipner
BACKGROUND: Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. OBJECTIVE: To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. DESIGN: Historical population cohort study...
March 7, 2018: Journal of General Internal Medicine
Mohanraj Thirumalai, William B Kirkland, Samuel R Misko, Sangeetha Padalabalanarayanan, Laurie A Malone
BACKGROUND: Active video game (AVG) playing, also known as "exergaming," is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) design poses several limitations. It is inaccessible to wheelchair users, does not support the use of stabilization assistive devices, and requires the ability to shift the center of balance (COB) in all directions to fully engage in game play...
March 6, 2018: JMIR Rehabilitation and Assistive Technologies
Milawaty Nurjono, Pami Shrestha, Alice Lee, Xin Ya Lim, Farah Shiraz, Shermin Tan, Shing Hei Wong, Kah Mun Foo, Thomas Wee, Sue-Anne Toh, Joanne Yoong, Hubertus Johannes Maria Vrijhoef
INTRODUCTION: The lack of understanding of how complex integrated care programmes achieve their outcomes due to the lack of acceptable methods leads to difficulties in the development, implementation, adaptation and scaling up of similar interventions. In this study, we evaluate an integrated care network, the National University Health System (NUHS) Regional Health System (RHS), consisting of acute hospitals, step down care, primary care providers, social services and community partners using a theory-driven realist evaluation approach...
March 1, 2018: BMJ Open
Kayoko Ohnishi, Kazuyo Kitaoka, Jun Nakahara, Maritta Välimäki, Raija Kontio, Minna Anttila
BACKGROUND: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress...
January 1, 2018: Nursing Ethics
Mami Iima, Masako Kataoka, Shotaro Kanao, Makiko Kawai, Natsuko Onishi, Sho Koyasu, Katsutoshi Murata, Akane Ohashi, Rena Sakaguchi, Kaori Togashi
We prospectively examined the variability of non-Gaussian diffusion magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) measurements with different numbers of b-values and excitations in normal breast tissue and breast lesions. Thirteen volunteers and fourteen patients with breast lesions (seven malignant, eight benign; one patient had bilateral lesions) were recruited in this prospective study (approved by the Internal Review Board). Diffusion-weighted MRI was performed with 16 b-values (0-2500 s/mm2 with one number of excitations [NEX]) and five b-values (0-2500 s/mm2, 3 NEX), using a 3T breast MRI...
2018: PloS One
Daniel Jurich, Lauren M Duhigg, Troy J Plumb, Steven A Haist, Janine L Hawley, Rebecca S Lipner, Laurel Smith, Suzanne M Norby
BACKGROUND AND OBJECTIVES: Medical specialty and subspecialty fellowship programs administer subject-specific in-training examinations to provide feedback about level of medical knowledge to fellows preparing for subsequent board certification. This study evaluated the association between the American Society of Nephrology In-Training Examination and the American Board of Internal Medicine Nephrology Certification Examination in terms of scores and passing status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study included 1684 nephrology fellows who completed the American Society of Nephrology In-Training Examination in their second year of fellowship training between 2009 and 2014...
February 28, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Rosa Sze Man Wong, Esther Yee Tak Yu, Vivian Yawei Guo, Eric Yuk-Fai Wan, Weng-Yee Chin, Carlos King Ho Wong, Colman Siu Cheung Fung, Keith Tsz Suen Tung, Wilfred Hing-Sang Wong, Patrick Ip, Agnes Fung Yee Tiwari, Cindy Lo Kuen Lam
INTRODUCTION: Chronic stress has adverse effects on health. Adults and children from low-income families are subject to multiple sources of stress. Existing literature about economic hardship mostly focuses on either adults or children but not both. Moreover, there is limited knowledge on the relationship between parental generalised stress and child health problems. This study aims to explore the bidirectional relationship between parental stress and child health in Chinese low-income families and to identify other modifiable factors influencing this relationship...
February 22, 2018: BMJ Open
Merete Osler, Erik L Mortensen, Kaare Christensen, Gunhild T Christensen
Aim: To investigate the bidirectional association between cognitive ability in young adulthood and epilepsy. Methods: This cohort study included 1 159 076 men enrolled in the mandatory conscription board examination from the Danish Conscription Database (DCD; 658 465 men examined 1957-84), the Danish Defence Personnel Organization Database (DPOD; 216 509 men examined 1987-2005) and the Danish Conscription Registry (DCR; 284 102 men examined 2006-15). A supplementary analysis included 14 814 female volunteers...
February 14, 2018: International Journal of Epidemiology
Gary L Freed, Debra M Boyer, Kenton D Van, Michelle L Macy, Julie McCormick, Laurel K Leslie
OBJECTIVE: To assess the part-time workforce and average hours worked per week among pediatric subspecialists in the 15 medical subspecialties certified by the American Board of Pediatrics. STUDY DESIGN: We examined data from pediatric subspecialists who enrolled in Maintenance of Certification with the American Board of Pediatrics from 2009 to 2015. Data were collected via an online survey. Providers indicated whether they worked full time or part time and estimated the average number of hours worked per week in clinical, research, education, and administrative tasks, excluding time on call...
January 29, 2018: Journal of Pediatrics
Adam A Liudahl, Andrew B Davis, Danielle S Liudahl, Joan Maley, Bruno Policeni, Marlan R Hansen
OBJECTIVES/HYPOTHESIS: The objectives of this study were to evaluate the diagnostic accuracy of constructive interference steady state (CISS) sequencing compared to gadolinium-enhanced T1 (GdT1) magnetic resonance imaging (MRI) to screen for small vestibular schwannomas (VSs), and to assess the overall diagnostic confidence of neuroradiologists in their ability to accurately diagnose or rule out VSs using CISS imaging compared to a GdT1 MRI STUDY DESIGN: Retrospective chart review. METHODS: Chart review from 2011 to 2015 was performed for VS/benign cerebellopontine angle tumors...
February 2, 2018: Laryngoscope
Ernest Usang Ekpo, Thomas Adejoh, Judith David Akwo, Christian Emeka Onwujekwe, Alhaji Modu Ali, Mohammed Abba, Kudirat Adesina, Oselumenosen David Omiyi, Uche H Chiegwu
To explore doses from common adult computed tomography (CT) examinations and propose a national diagnostic reference levels (nDRLs) for Nigeria. Materials and Methods: This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose survey of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders...
January 29, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Sergei Muratov, Justin Lee, Anne Holbrook, J Michael Paterson, Jason Robert Guertin, Lawrence Mbuagbaw, Tara Gomes, Wayne Khuu, Priscila Pequeno, Andrew P Costa, Jean-Eric Tarride
INTRODUCTION: Senior high-cost users (HCUs) are estimated to represent 60% of all HCUs in Ontario, Canada's most populous province. To improve our understanding of individual and health system characteristics related to senior HCUs, we will examine incident senior HCUs to determine their incremental healthcare utilisation and costs, characteristics of index hospitalisation episodes, mortality and their regional variation across Ontario. METHODS AND ANALYSIS: A retrospective, population-based cohort study using administrative healthcare records will be used...
December 26, 2017: BMJ Open
Joan E Steffen, Ella A Fassler, Kevin J Reardon, David S Egilman
In 2001, DePuy, a wholly-owned subsidiary of Johnson & Johnson (J&J/DePuy), initiated a seeding study called the "Multi-center, Prospective, Clinical Evaluation of Pinnacle Acetabular Implants in Total Hip Arthroplasty" (PIN Study). J&J/DePuy designed this study to develop new business opportunities during the launch of their Pinnacle Hip System (PHS) and generate survivorship data for marketing. This article, the first review of a seeding trial for a medical device, examines internal company documents relating to the PIN Study; the analysis herein focuses on the integrity of J&J/DePuy's research practices in conception, implementation, and analysis...
2018: Accountability in Research
Weston Stover, Sujata Gill, Kim Schenarts, A Alfred Chahine
OBJECTIVE: In the spring of 2010, a categorical general surgery postgraduate year (PGY)-2 position became available at our academic medical center secondary to attrition of a PGY-1 resident. We sought to study the unique characteristics of applicants to that position and to describe the selection process with hopes to stimulate additional studies about the unique challenges of recruiting applicants into advanced standing positions. DESIGN: Applications were received via e-mail and reviewed to characterize the applicant pool...
December 11, 2017: Journal of Surgical Education
Ori Nevo, Richard Brown, Phyllis Glanc, Ken Lim
OBJECTIVE: This guideline presents an evidence-based technical update and recommendations for the performance of early comprehensive fetal anatomic scanning (ECFAS) at 11 to 16 weeks' gestation. OPTIONS: Patients at high risk for fetal anomalies and in whom traditional mid-second trimester transabdominal imaging may be challenging or who may benefit from earlier identification of fetal anomalies may be suitable for early fetal anatomy scanning. OUTCOMES: This practice may result in earlier identification of fetal anomalies and provide earlier intervention options in high-risk populations and/or in populations where mid-second trimester transabdominal scanning is challenging...
December 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Erica K Schuster, Lars E Peterson
BACKGROUND AND OBJECTIVES: Population health management (PHM) is an important function of primary care with potential to improve outcomes and decrease costs, but is also among the most difficult strategies to implement in both practices and residency training. Our objective was to determine resident and residency program characteristics associated with graduates' reported preparation to perform PHM. METHODS: We used data from the American Board of Family Medicine (ABFM) Certification Examination registration questionnaire in 2014 and 2015 and ABFM administrative data...
November 2017: Family Medicine
Michael R Peabody, Thomas R O'Neill, Aimee R Eden, James C Puffer
BACKGROUND: Due to the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) single-accreditation model, the specialty of family medicine may see as many as 150 programs and 500 trainees in AOA-accredited programs seek ACGME accreditation. This analysis serves to better understand the composition of physicians completing family medicine residency training and their subsequent certification by the American Board of Family Medicine. METHODS: We identified residents who completed an ACGME-accredited or dual-accredited family medicine residency program between 2006 and 2016 and cross-tabulated the data by graduation year and by educational background (US Medical Graduate-MD [USMG-MD], USMG-DO, or International Medical Graduate-MD [IMG-MD]) to examine the cohort composition trend over time...
November 2017: Journal of the American Board of Family Medicine: JABFM
Birong Dong, Jirong Yue, Li Cao, Ming Yang, Ning Ge, Hao Qiukui, Lujia He, Ying Wang, Joseph H Flaherty
China has the world's largest elderly population, and the oldest-old population, with a current disability rate greater than 50%, will triple in the next 35 years. The field of geriatrics is young, because almost all geriatric departments were established after 2000, and so faces many challenges. Management of diseases and hospital care is the focus. Senior physicians were trained in other subspecialties, such as pulmonary or cardiology, and junior physicians entered geriatrics departments as masters or doctorate students after medical school...
November 23, 2017: Journal of the American Geriatrics Society
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