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Patient's preception

Richard A Young, Sandra K Burge, Kaparaboyna A Kumar, Jocelyn M Wilson, Daniela F Ortiz
BACKGROUND AND OBJECTIVES: Electronic health records (EHRs) have had mixed effects on the workflow of ambulatory primary care. In this study, we update previous research on the time required to care for patients in primary care clinics with EHRs. METHODS: We directly observed family physician (FP) attendings, residents, and their ambulatory patients in 982 visits in clinics affiliated with 10 residencies of the Residency Research Network of Texas. The FPs were purposely chosen to reflect a diversity of patient care styles...
February 2018: Family Medicine
Christina M Astley, Jennifer N Todd, Rany M Salem, Sailaja Vedantam, Cara B Ebbeling, Paul L Huang, David S Ludwig, Joel N Hirschhorn, Jose C Florez
BACKGROUND: A fundamental precept of the carbohydrate-insulin model of obesity is that insulin secretion drives weight gain. However, fasting hyperinsulinemia can also be driven by obesity-induced insulin resistance. We used genetic variation to isolate and estimate the potentially causal effect of insulin secretion on body weight. METHODS: Genetic instruments of variation of insulin secretion [assessed as insulin concentration 30 min after oral glucose (insulin-30)] were used to estimate the causal relationship between increased insulin secretion and body mass index (BMI), using bidirectional Mendelian randomization analysis of genome-wide association studies...
January 2018: Clinical Chemistry
Sanjay Kalra, Ameya Joshi, Bharti Kalra, Vivekanand G Shanbhag, Rajib Bhattacharya, Komal Verma, Manash P Baruah, Rakesh Sahay, Sarita Bajaj, Navneet Agrawal, Ashim Chakraborty, Yatan Pal Singh Balhara, Sandeep Chaudhary, Deepak Khandelwal, Sameer Aggarwal, Nanik Ram, Jubbin Jacob, Sandeep Julka, Gagan Priya, Shelley Bhattacharya, Komal Dalal
This communication presents verses from the Bhagavad Gita which help define a good clinician's skills and behavior. Using the teachings of Lord Krishna, these curated verses suggest three essential skills that a physician must possess: Excellent knowledge, equanimity, and emotional attributes. Three good behaviors are listed (Pro-work ethics, Patient-centered care, and Preceptive leadership) and supported by thoughts written in the Gita.
November 2017: Indian Journal of Endocrinology and Metabolism
Dema Mohammed, Kyle Turner, Kylee Funk
INTRODUCTION: The role of pharmacy students in student-run free clinics (SRFCs) across the United States has not been well-defined. This study sought to assess the level of involvement and roles of pharmacy students in SRFCs as well as their interprofessional collaboration. METHODS: An online survey was sent to each pharmacy school registered with the American Association of Colleges of Pharmacy (AACP). The survey addressed the following concepts within SRFCs: pharmacy student roles, precepting and school of pharmacy involvement, interprofessional experience, leadership positions held by pharmacy students, and dissemination of feedback in this service-learning experience...
January 2018: Currents in Pharmacy Teaching & Learning
Livia R M McCutcheon, Kathryn Whitcomb, Craig D Cox, Mary S Klein, Hansel Burley, Terrance Youngblood, Cynthia Raehl
BACKGROUND AND PURPOSE: Interprofessional education (IPE) is important in the education of all health care students, yet limited IPE training has been provided to preceptors who train these students in the clinical setting. Simulation using the standardized student model has been used to train health care preceptors in medicine. To our knowledge, there are no reports utilizing interprofessional objective structured teaching exercises (iOSTE) to train pharmacy preceptors. The primary objectives of this pilot study were to evaluate the effects of iOSTE on the pharmacy preceptors' perceived importance of the Interprofessional Education Collaborative (IPEC) core competencies and confidence in precepting interprofessional students...
July 2017: Currents in Pharmacy Teaching & Learning
Jeanne Moore, Petra Goodman, Janet Selway, Elizabeth Hawkins-Walsh, Janet Merritt, Jill Dombrowski
BACKGROUND: Substance use disorders are a major public health problem. As primary care providers, nurse practitioners (NPs) must be proficient at screening, identifying, and intervening for at-risk patients. Screening, brief intervention, and referral to treatment (SBIRT) is a well-established, evidence-based model for teaching behavioral health skills to health care providers. It is vital that Master of Science in Nursing (MSN)-NP programs incorporate SBIRT into their curricula. METHOD: SBIRT content was mapped to 10 courses across an MSN-NP program...
December 1, 2017: Journal of Nursing Education
Amanda E Ward, Sara A McComb
AIMS AND OBJECTIVES: To elucidate the terminology associated with preceptorships, articulate an operational description of preceptorship that may be useful in formalising the precepting process and provide guidance for constructing a clinical environment where precepting can thrive. BACKGROUND: Precepting facilitates the transition of nurses into new roles. Precepting may improve patient outcomes and safety, as well as enhance nursing satisfaction. Most research focuses on preceptor preparation and perceptions...
November 30, 2017: Journal of Clinical Nursing
Janya Chimluang, Sureeporn Thanasilp, Lanchasak Akkayagorn, Ratchaneekorn Upasen, Noppamat Pudtong, Wilailuck Tantitrakul
PURPOSE: To evaluate the effect of an intervention based on basic Buddhist principles on the spiritual well-being of patients with terminal cancer. METHODS: This quasi-experimental research study had pre- and post-test control groups. The experimental group received conventional care and an intervention based on basic Buddhist principles for three consecutive days, including seven activities based on precept activities, concentration activities and wisdom activities...
December 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Jakobus M Louw, Tessa S Marcus, Johannes F M Hugo
BACKGROUND: Person-centred practice in medicine may provide solutions to several pressing problems in health care, including the cost of services, poor outcomes in chronic care and the rise in litigation. It is also an ethical imperative in itself. However, patient- or person-centred care is not well researched partly because of a lack of conceptual and definitional clarity. AIM: The aim of this review was to analyse essential elements, ethical principles, logic and the practical application of person-centred practice described in clinician- and researcher-defined conceptual frameworks, terms and practices...
October 19, 2017: African Journal of Primary Health Care & Family Medicine
Meredith A Rooth, Margaret T Dillon, Kevin D Brown
OBJECTIVE: Translabyrinthine (TL) vestibular schwannoma (VS) resection may be accomplished with preservation of the cochlear nerve, permitting successful, concurrent cochlear implantation. In this single institution, Food and Drug Administration-approved feasibility study, we wished to determine the success and outcomes of concurrent cochlear implantation at the time of TL resection of VS. STUDY DESIGN: Prospective cohort. SETTING: Tertiary referral center...
December 2017: Otology & Neurotology
Lilla Náfrádi, Zlatina Kostova, Kent Nakamoto, Peter J Schulz
Objectives To study patients' perspectives about the role of the doctor-patient relationship in promoting the resilience process. Methods We conducted in-depth interviews with 20 chronic pain patients. Using open-ended questions, the interviews explored aspects of the doctor-patient relationship that impacted the patients' perceptions of their resilience. Thematic analysis built on an inductive, adaptive approach to data coding was employed to organize a representation of key factors affecting resilience. Results The themes emerging from the interviews inform us about how the different aspects of the doctor-patient relationship can promote patient resilience in chronic pain...
January 1, 2017: Chronic Illness
Padmore Adusei Amoah, David R Phillips
The referral system in health care has been noted as very influential in determining which services are accessed and when. Nonetheless, existing studies have relied on specific measurable factors relating to health personnel, transportation and communication infrastructure, and finance to explain the challenges facing the referral policy in developing countries. While this is understandable, the role of social capital remains mostly uncharted even though it is implicit in the well-known lay referral system...
October 25, 2017: Healthcare (Basel, Switzerland)
Sasheen Pack, Peter Y Hahn, James K Stoller, Srinivas R Mummadi
BACKGROUND: Usual practice in community health-care settings indicates that arterial catheters are inserted by physicians. In the context of a respiratory therapist (RT)-managed arterial catheter placement protocol being implemented in our community hospital, the current study describes the implementation and outcomes of this RT-managed arterial catheter insertion and maintenance program. METHODS: Tuality Healthcare is a 215-bed community health-care system (10-bed ICU) in Hillsboro, Oregon...
October 3, 2017: Respiratory Care
Robert Ignoffo, Lucinda Chan, Katherine Knapp, Emily Chan, Eric Ip, Jason Bandy, Kathleen Besinque, James Colbert, Jeremiah J Duby, Joseph S Galanto, Mark Gloudeman, Patty Havard, Grant Lackey, Eric Lozano, James Scott, Tania L Stewart
PURPOSE: Using the Delphi process, a panel of experienced preceptors achieved consensus on best practices to increase preceptor efficiency and effectiveness. METHODS: The Delphi panelists completed 3 survey rounds and a face-to-face meeting. Survey questions covered several topics, including preparation of students for rotations, preceptor efficiency and effectiveness, potential resident contributions to precepting, methods of developing critical-thinking skills and providing assessment and feedback, precepting time metrics, and barriers to preceptor effectiveness...
August 22, 2017: American Journal of Health-system Pharmacy: AJHP
Johnnie R Robbins, Krystal K Valdez-Delgado, Nicole W Caldwell, Linda H Yoder, Elizabeth J Hayes, Michaèl G Barba, Hope L Greeley, Colleen Mitchell, Elizabeth A Mann-Salinas
INTRODUCTION: There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty...
November 2017: Burns: Journal of the International Society for Burn Injuries
Daiana Patrícia Marchetti Pio, Lilian Andreia Fleck Reinato, Letícia Pimenta Lopes, Juliano de Souza Caliari, Elucir Gir
Objective: Identify the rate and predictive factors of the hospitalization of people living with HIV/AIDS (PLHA), aged 50 years or older. Method: A quantitative, cross-sectional study was conducted at two inpatient units specialized in infectious diseases in a teaching hospital. Data were gathered through individual interviews between August 2011 and February 2015. All ethical precepts were followed. Results: Of the 532 admitted patients, 95 were PLHA 50 years old or older; 30...
July 2017: Revista Brasileira de Enfermagem
Daniela J Conrado, Timothy Nicholas, Kuenhi Tsai, Sreeraj Macha, Vikram Sinha, Julie Stone, Brian Corrigan, Massimo Bani, Pierandrea Muglia, Ian A Watson, Volker D Kern, Elena Sheveleva, Kenneth Marek, Diane T Stephenson, Klaus Romero
Given the recognition that disease-modifying therapies should focus on earlier Parkinson's disease stages, trial enrollment based purely on clinical criteria poses significant challenges. The goal herein was to determine the utility of dopamine transporter neuroimaging as an enrichment biomarker in early motor Parkinson's disease clinical trials. Patient-level longitudinal data of 672 subjects with early-stage Parkinson's disease in the Parkinson's Progression Markers Initiative (PPMI) observational study and the Parkinson Research Examination of CEP-1347 Trial (PRECEPT) clinical trial were utilized in a linear mixed-effects model analysis...
July 27, 2017: Clinical and Translational Science
Liz Forbat, Rowena Robinson, Rachel Bilton-Simek, Karemah Francois, Marsha Lewis, Erna Haraldsdottir
BACKGROUND: Face-to-face/group education for palliative caregivers is successful, but relies on caregivers travelling, being absent from the patient, and rigid timings. This presents inequities for those in rural locations. AIM: To design and test an innovative distance-learning educational package (PrECEPt: PalliativE Caregivers Education Package). DESIGN: Single-arm mixed-method feasibility proof-of-concept trial (ACTRN12616000601437). The primary outcome was carer self-efficacy, with secondary outcomes focused on caregiver preparedness and carer tasks/needs...
June 1, 2017: Palliative Medicine
Brittany M Loy, Sendra Yang, Jason M Moss, Debra W Kemp, Jamie N Brown
The layered learning practice model (LLPM) is a teaching strategy designed to train residents to precept students and other residents with the oversight of a seasoned clinical pharmacist. This model serves as a tool for residency programs to implement quality precepting opportunities and learning experiences as they look for new ways to integrate multiple learners into the practice setting. The levels of the LLPM include a senior preceptor, resident, and student. It is best implemented through utilization of 4 steps: orientation to the LLPM, preexperience planning, implementation, and postexperience evaluation...
April 2017: Hospital Pharmacy
Marcelo Rossiti Florian, Vera Lucia Rasera Zotelli, Maria da Luz Rosário de Sousa, Larissa Angélica Bachir Polloni
Temporomandibular disorder (TMD) is ranked the second leading cause of orofacial pain after toothache, and there is no effective standard treatment for all cases. Therefore, much research has been conducted in the therapeutic areas of TMD, such as acupuncture and electrotherapy, for this purpose. The aim of this research was to evaluate application of the neuromagnetic stimulator device Haihua model CD-9, used within the precepts of acupuncture in treating TMD-related pain symptoms and limited mouth opening...
April 2017: Journal of Acupuncture and Meridian Studies
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