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Clinical competence

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https://www.readbyqxmd.com/read/28449293/a-novel-approach-to-study-medical-decision-making-in-the-clinical-setting-the-own-point-of-view-perspective
#1
Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Bernard Charlin
BACKGROUND: Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision-making in an authentic setting are increasing significantly. They are based on the use of qualitative methods which are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording...
April 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28447404/potential-biomechanical-roles-of-risk-factors-in-the-evolution-of-thrombus-laden-abdominal-aortic-aneurysms
#2
Lana Virag, John S Wilson, Jay D Humphrey, Igor Karšaj
Abdominal aortic aneurysms (AAAs) typically harbour an intraluminal thrombus (ILT), yet most prior computational models neglect biochemomechanical effects of thrombus on lesion evolution. We recently proposed a growth and remodelling model of thrombus-laden AAAs that introduced a number of new constitutive relations and associated model parameters. Because values of several of these parameters have yet to be elucidated by clinical data, and could vary significantly from patient to patient, the aim of this study was to investigate the possible extent to which these parameters influence AAA evolution...
April 26, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28446852/clinical-performance-of-emergency-surgical-officers-in-southern-ethiopia
#3
Abera A Gobeze, Zelalem Kebede, Yifru Berhan, Biku Ghosh
BACKGROUND: Serious shortage of gynecologists and surgeons for several decades leading to a three-year masters level training was initiated in 2009. However, systematic analysis was not done to assess the graduates' performance. The purpose of this study was to assess improvement in access to emergency surgical and obstetrical care services. METHODS: Both quantitative and qualitative methods were employed to assess the competence of emergency surgical officers (ESOs) in their decision making and surgical skills in eight hospitals between 2012 and 2014...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28445215/promoting-learning-and-patient-care-through-shared-reflection-a-conceptual-framework-for-team-reflexivity-in-health-care
#4
Jan B Schmutz, Walter J Eppich
Health care teams are groups of highly skilled experts who may often form inexpert teams because of a lack of collective competence. Because teamwork and collaboration form the foundation of effective clinical practice, factors that promote collective competence demand exploration. The authors review team reflexivity (TR), a concept from psychology and management literatures, and how it could contribute to the collective competence of health care teams. TR captures a team's ability to reflect collectively on group objectives, strategies, goals, processes, and outcomes of past, current, and future performance to process key information and adapt accordingly...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28444290/low-density-lipoproteins-cause-atherosclerotic-cardiovascular-disease-1-evidence-from-genetic-epidemiologic-and-clinical-studies-a-consensus-statement-from-the-european-atherosclerosis-society-consensus-panel
#5
Brian A Ference, Henry N Ginsberg, Ian Graham, Kausik K Ray, Chris J Packard, Eric Bruckert, Robert A Hegele, Ronald M Krauss, Frederick J Raal, Heribert Schunkert, Gerald F Watts, Jan Borén, Sergio Fazio, Jay D Horton, Luis Masana, Stephen J Nicholls, Børge G Nordestgaard, Bart van de Sluis, Marja-Riitta Taskinen, Lale Tokgözoglu, Ulf Landmesser, Ulrich Laufs, Olov Wiklund, Jane K Stock, M John Chapman, Alberico L Catapano
Aims: To appraise the clinical and genetic evidence that low-density lipoproteins (LDLs) cause atherosclerotic cardiovascular disease (ASCVD). Methods and results: We assessed whether the association between LDL and ASCVD fulfils the criteria for causality by evaluating the totality of evidence from genetic studies, prospective epidemiologic cohort studies, Mendelian randomization studies, and randomized trials of LDL-lowering therapies. In clinical studies, plasma LDL burden is usually estimated by determination of plasma LDL cholesterol level (LDL-C)...
April 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28444105/clinical-pathological-and-demographic-factors-associated-with-development-of-recurrences-after-surgical-resection-in-elderly-patients-with-neuroendocrine-tumors
#6
C Shen, A Dasari, Y Chu, D M Halperin, S Zhou, Y Xu, Y T Shih, J C Yao
Background: Incidence of locoregional neuroendocrine tumors (NETs) is rising. However, after curative resection, the patterns and risk factors associated with recurrence remain unknown. Consensus guidelines recommend surveillance every 6-12 months for up to 10 years after surgery for resected, well-differentiated NETs irrespective of patient demographics, site, grade or stage of tumor with few exceptions. Patients and Methods: From the Surveillance, Epidemiology and End Results (SEER)-Medicare database, we identified localized and regional stage NET patients who underwent surgical resection between 1/2002 and 12/2011...
April 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28442602/molecular-basis-of-metabolism-mediated-conversion-of-pk11195-from-an-antagonist-to-an-agonist-of-the-constitutive-androstane-receptor
#7
Bryan Mackowiak, Linhao Li, Matthew A Welch, Daochuan Li, Jace W Jones, Scott Heyward, Maureen A Kane, Peter W Swaan, Hongbing Wang
The constitutive androstane receptor (CAR) plays an important role in xenobiotic metabolism, energy homeostasis, and cell proliferation. Antagonism of CAR represents a key strategy for studying its function and may have potential clinical applications. However, specific human CAR (hCAR) antagonists are limited and conflicting data on the activity of these compounds have been reported. PK11195, a typical peripheral benzodiazepine receptor ligand, has been established as a potent hCAR deactivator in immortalized cells; whether it inhibits hCAR activity under physiologically-relevant conditions remains unclear...
April 25, 2017: Molecular Pharmacology
https://www.readbyqxmd.com/read/28442454/impact-of-information-and-communication-technologies-on-nursing-care-results-of-an-overview-of-systematic-reviews
#8
Geneviève Rouleau, Marie-Pierre Gagnon, José Côté, Julie Payne-Gagnon, Emilie Hudson, Carl-Ardy Dubois
BACKGROUND: Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care. OBJECTIVE: An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs. METHODS: Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included...
April 25, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28442054/when-colocation-is-not-enough-a-case-study-of-general-practitioner-super-clinics-in-australia
#9
Riki Lane, Grant Russell, Elizabeth A Bardoel, Jenny Advocat, Nicholas Zwar, P Gawaine Powell Davies, Mark F Harris
Developed nations are implementing initiatives to transform the delivery of primary care. New models have been built around multidisciplinary teams, information technology and systematic approaches for chronic disease management (CDM). In Australia, the General Practice Super Clinic (GPSC) model was introduced in 2010. A case study approach was used to illustrate the development of inter-disciplinary CDM over 12 months in two new, outer urban GPSCs. A social scientist visited each practice for two 3-4-day periods...
April 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28441936/rationale-and-design-of-bistro-a-randomized-controlled-trial-to-determine-whether-bioimpedance-spectroscopy-guided-fluid-management-maintains-residual-kidney-function-in-incident-haemodialysis-patients
#10
Simon J Davies, Fergus J Caskey, David Coyle, Elizabeth Lindley, Jamie Macdonald, Sandip Mitra, Martin Wilkie, Andrew Davenport, Ken Farrington, Indranil Dasgupta, Paula Ormandy, Lazaros Andronis, Ivonne Solis-Trapala, Julius Sim
BACKGROUND: Preserved residual kidney function (RKF) and normal fluid status are associated with better patient outcomes in incident haemodialysis patients. The objective of this trial is to determine whether using bioimpedance technology in prescribing the optimal post-dialysis weight can reduce the rate of decline of RKF and potentially improve patient outcomes. METHODS/DESIGN: 516 pateints commencing haemodialysis, aged >18 with RKF of > 3 ml/min/1...
April 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28439354/residents-procedural-experience-does-not-ensure-competence-a-research-synthesis
#11
Jeffrey H Barsuk, Elaine R Cohen, Joe Feinglass, William C McGaghie, Diane B Wayne
BACKGROUND: Many medical certifying bodies require that a minimum number of clinical procedures be completed during residency training to obtain board eligibility. However, little is known about the relationship between the number of procedures residents perform and their clinical competence. OBJECTIVE: This study evaluated associations between residents' medical procedure skills measured in a simulation laboratory and self-reported procedure experience and year of training...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439353/improving-timely-resident-follow-up-and-communication-of-results-in-ambulatory-clinics-utilizing-a-web-based-audit-and-feedback-module
#12
Joel C Boggan, Aparna Swaminathan, Samantha Thomas, David L Simel, Aimee K Zaas, Jonathan G Bae
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE: This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS: We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439346/cognitive-demands-and-bias-challenges-facing-clinical-competency-committees
#13
Chandlee C Dickey, Christopher Thomas, Usama Feroze, Firas Nakshabandi, Barbara Cannon
No abstract text is available yet for this article.
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439242/comprehensive-psychopathological-assessment-based-on-the-association-for-methodology-and-documentation-in-psychiatry-amdp-system-development-methodological-foundation-application-in-clinical-routine-and-research
#14
REVIEW
Rolf-Dieter Stieglitz, Achim Haug, Erdmann Fähndrich, Michael Rösler, Wolfgang Trabert
The documentation of psychopathology is core to the clinical practice of the psychiatrist and clinical psychologist. However, both in initial as well as further training and specialization in their fields, this particular aspect of their work receives scanty attention only. Yet, for the past 50 years, the Association for Methodology and Documentation in Psychiatry (AMDP) System has been in existence and available as a tool to serve precisely the purpose of offering a systematic introduction to the terminology and documentation of psychopathology...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28438565/improvements-in-oocyte-competence-in-superovulated-mice-following-treatment-with-cilostazol-ovulation-of-immature-oocytes-with-high-developmental-rates
#15
Ahmed M Taiyeb, Saeeda A Muhsen-Alanssari, William L Dees, Jill Hiney, Michael E Kjelland, Duane C Kraemer, Mundhir T Ridha-Albarzanchi
Exogenous administration of superovulatory hormones negatively affects oocyte competence in mammals. Phosphodiesterase 3A inhibitors were found to improve competence of oocytes matured in vitro in several species, including humans. This study was therefore designed to define oocyte maturation synchronization and competence in superovulated mice treated with cilostazol, a selective phosphodiesterase 3A inhibitor. Swiss Webster mice were superovulated and treated orally with 7.5mg cilostazol once or twice to result in ovulation of immature oocytes at the metaphase I (MI) or germinal vesicle (GV) stage, respectively...
April 21, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28438196/examiner-effect-on-the-objective-structured-clinical-exam-a-study-at-five-medical-schools
#16
Iris Schleicher, Karsten Leitner, Jana Juenger, Andreas Moeltner, Miriam Ruesseler, Bernd Bender, Jasmina Sterz, Karl-Friedrich Schuettler, Sarah Koenig, Joachim Gerhard Kreuder
BACKGROUND: The Objective Structured Clinical Examination (OSCE) is increasingly used at medical schools to assess practical competencies. To compare the outcomes of students at different medical schools, we introduced standardized OSCE stations with identical checklists. METHODS: We investigated examiner bias at standardized OSCE stations for knee- and shoulder-joint examinations, which were implemented into the surgical OSCE at five different medical schools. The checklists for the assessment consisted of part A for knowledge and performance of the skill and part B for communication and interaction with the patient...
April 24, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28437477/outcomes-after-antiretroviral-therapy-during-the-expansion-of-hiv-services-in-haiti
#17
Margaret L McNairy, Patrice Joseph, Michelle Unterbrink, Stanislas Galbaud, Jean-Edouard Mathon, Vanessa Rivera, Deanna Jannat-Khah, Lindsey Reif, Serena P Koenig, Jean Wysler Domercant, Warren Johnson, Daniel W Fitzgerald, Jean W Pape
BACKGROUND: We report patient outcomes after antiretroviral therapy (ART) initiation in a network of HIV facilities in Haiti, including temporal trends and differences across clinics, during the expansion of HIV services in the country. METHODS: We assessed outcomes at 12 months after ART initiation (baseline) using routinely collected data on adults (≥15 years) in 11 HIV facilities from July 2007-December 2013. Outcomes include death (ascertained from medical records), lost to follow-up (LTF) defined as no visit > 365 days from ART initiation, and retention defined as being alive and attending care ≥ 365 days from ART initiation...
2017: PloS One
https://www.readbyqxmd.com/read/28435782/thoracic-ultrasound-what-non-radiologists-need-to-know
#18
REVIEW
Jonathan P Williamson, Chris Grainge, Ahilan Parameswaran, Scott H Twaddell
PURPOSE OF REVIEW: The aim of this review is to provide the theoretical and practical knowledge essential for non-radiologists to develop the skills necessary to apply thoracic ultrasound as an extension of clinical assessment and intervention. RECENT FINDINGS: Issues relating to training and competence are discussed and a library of thoracic ultrasound videos is provided to illustrate artefacts, pleural, parenchymal and pneumothorax pathology as well as important pitfalls to consider...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28435691/interrupting-antiretroviral-treatment-in-hiv-cure-research-scientific-and-ethical-considerations
#19
EDITORIAL
Samual A Garner, Stuart Rennie, Jintanat Ananworanich, Karine Dube, David M Margolis, Jeremy Sugarman, Randall Tressler, Adam Gilbertson, Liza Dawson
Over the past several years there has been intense activity directed at the possibility of achieving remission or eradication of HIV infection. Current assays for the measurement of latent HIV are insufficient to demonstrate complete clearance of replication-competent HIV. Therefore, the ultimate test for assessing whether investigational interventions have resulted in HIV remission or eradication is to interrupt standard antiretroviral therapy (ART) in a carefully controlled clinical trial setting. These procedures, known as analytic treatment interruptions (ATIs), raise important scientific and ethical questions...
April 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28435360/the-confidence-of-undergraduate-dental-students-in-saudi-arabia-in-performing-endodontic-treatment
#20
Mothanna Alrahabi
OBJECTIVE: This study examined the endodontic experience, perceptions of endodontic practice, and self-rated confidence of dental students enrolled in Taibah University, Saudi Arabia. MATERIALS AND METHODS: A questionnaire was distributed to 41 undergraduate dental students registered in endodontic courses in the 2015 academic year. The questionnaire evaluated their confidence performing nonsurgical root canal treatment. The level of confidence was classified using a 5-point scale as "very confident," "confident," "neutral," "not very confident," or "not at all confident...
January 2017: European Journal of Dentistry
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