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Family practice medicine

Thaddeus Mason Pope
This symposium includes twelve personal narratives from those who have personally participated in voluntarily stopping eating and drinking (VSED). This issue also includes three commentaries on these narratives by experts in philosophy, palliative care, and hospice medicine. The successes, challenges, and observations described by these narrative and commentary authors will not only inform the academic debate about the legitimacy of VSED but will also inform much needed practical guidance for patients, clinicians, and family members on how they can best implement and support VSED...
2016: Narrative Inquiry in Bioethics
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Richard K Zimmerman, Anthony E Brown, Valory N Pavlik, Krissy K Moehling, Jonathan M Raviotta, Chyongchiou J Lin, Song Zhang, Mary Hawk, Shakala Kyle, Suchita Patel, Faruque Ahmed, Mary Patricia Nowalk
OBJECTIVES: To test the effectiveness of a step-by step, evidence-based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination. DESIGN: Randomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre-post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions...
October 18, 2016: Journal of the American Geriatrics Society
Fanny Orlhac, Christophe Nioche, Michael Soussan, Irene Buvat
INTRODUCTION: The use of texture indices (TI) to characterize tumor heterogeneity from Positron Emission Tomography (PET) images is increasingly investigated in retrospective studies. Yet, the interpretation of PET-derived TI values has not been thoroughly reported. Furthermore, the calculation of TI lacks a standardized methodology, making it difficult to compare published results. To allow for TI value interpretation, we investigated the changes in value of six TI computed from simulated and real patient data...
October 6, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Rocío Rojí, Antonio Noguera-Tejedor, Fernando Pikabea-Díaz, José Miguel Carrasco, Carlos Centeno
CONTEXT: A mandatory course in palliative care (PC) is organized for all final-year medical students at the University of Navarre. It consists of 24 lectures, 4 workshops, and 1 scheduled five hour clinical PC service experience at two different sites. In the 48 hours after the visit and related to the clinical experience, each student has to complete a 500-word reflective writing (RW) piece. OBJECTIVE: To investigate how a brief PC clinical experience helps equip the medical student...
October 18, 2016: Journal of Palliative Medicine
Dawn Schroeder, Wendy Duggleby, Brenda L Cameron
BACKGROUND: In families where genetic testing for the breast cancer 1 and 2 genes (BRCA1/2) has not identified a deleterious mutation, the risk for hereditary breast cancer (HBC) can still be high when there is a strong family history. Little is known about how an awareness of risk for HBC impacts the everyday lives of unaffected women (no personal history for breast and/or ovarian cancer) in these families. OBJECTIVE: The aim of this study is to explore how unaffected women, living in BRCA1/2-negative families, experience living with risk for HBC...
October 4, 2016: Cancer Nursing
Brian H Shirts, Colin C Pritchard, Tom Walsh
Every single-nucleotide change compatible with life is present in the human population today. Understanding these rare human variants defines an extraordinary challenge for genetics and medicine. The new clinical practice of sequencing many genes for hereditary cancer risk has illustrated the utility of clinical next-generation sequencing in adults, identifying more medically actionable variants than single-gene testing. However, it has also revealed a linear relationship between the length of DNA evaluated and the number of rare 'variants of uncertain significance' reported...
October 11, 2016: Trends in Molecular Medicine
Jennifer Pearson, Ruth Westra
BACKGROUND AND OBJECTIVES: The Department of Family Medicine and Community Health Duluth has offered the Obstetrical Longitudinal Course (OBLC) as an elective for first-year medical students since 1999. The objective of the OBLC Impact Survey was to assess the effectiveness of the course over the past 15 years. METHODS: A Qualtrics survey was emailed to participants enrolled in the course from 1999-2014. Data was compiled for the respondent group as a whole as well as four cohorts based on current level of training/practice...
October 2016: Family Medicine
Shelly Lachish, Elena Svirko, Michael J Goldacre, Trevor Lambert
BACKGROUND: The greater participation of women in medicine in recent years, and recent trends showing that doctors of both sexes work fewer hours than in the past, present challenges for medical workforce planning. In this study, we provide a detailed analysis of the characteristics of doctors who choose to work less-than-full-time (LTFT). We aimed to determine the influence of these characteristics on the probability of working LTFT. METHODS: We used data on working patterns obtained from long-term surveys of 10,866 UK-trained doctors...
October 13, 2016: Human Resources for Health
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
Paola Friedrich, Catherine G Lam, Geetinder Kaur, Elena Itriago, Raul C Ribeiro, Ramandeep S Arora
BACKGROUND: Understanding and addressing treatment abandonment (TxA) is crucial for bridging the pediatric cancer survival gap between high-income (HIC) and low-and middle-income countries (LMC). In childhood cancer, TxA is defined as failure to start or complete curative cancer therapy and known to be a complex phenomenon. With rising interest on causes and consequences of TxA in LMC, this study aimed to establish the lay-of-the-land regarding determinants of TxA globally, perform and promote comparative research, and raise awareness on this subject...
2016: PloS One
Manuel Monti, Giovanni Maria Vincentelli, Giuseppe Murdolo, Giuliano Bertazzoni, Francesco Rocco Pugliese, Francesco Borgognoni, Maria Pia Ruggieri, Raffaele Landolfi
INTRODUCTION: Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke and and the most common preventable cause of hospital-related death. Several studies have demonstrated a significant reduction of fatal pulmonary embolism attributed to the introduction of thromboprophylactic measures and changes in hospital practices. However, the influence of some demographical variables, especially age, has largely been under appreciated...
September 2016: Recenti Progressi in Medicina
Luigi Pagliaro, Agostino Colli
The clinician - the doctor who treats sick people - should be able to establish a good human relationship with his or her patients and their family; should be able to reach a diagnosis even in patients with rare diseases, or atypical presentations - or should refer the patient to a senior colleague; and should be able to recommend the best treatment (or no treatment at all). And he - or she - should be able to draw these abilities from the "deliberate practice" according to Ericsson, i.e. from the combination of experience with reflection - not, or with much lesser strength, from the medical literature as suggested by Evidence-Based Medicine...
September 2016: Recenti Progressi in Medicina
A K Lofters, M Slater, M Vahabi
Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice...
October 6, 2016: Journal of Immigrant and Minority Health
Elisabeth H Ference, Jin-Young Min, Rakesh K Chandra, James W Schroeder, Jody D Ciolino, Amy Yang, Jane Holl, Stephanie Shintani Smith
BACKGROUND: This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs). METHODS: Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates...
October 5, 2016: Annals of Otology, Rhinology, and Laryngology
Jonathan D Kibble, Christine Bellew, Abdo Asmar, Lisa Barkley
The goal of this review is to highlight the key elements needed to successfully deploy team-based learning (TBL) in any class, but especially in large enrolment classes, where smooth logistics are essential. The text is based on a lecture and workshop given at the American Physiological Society's Institute on Teaching and Learning in Madison, WI, in June 2016. After a short overview of the TBL method, its underpinning in learning theory, and a summary of current evidence for its effectiveness, we present two case studies from our own teaching practices in a new medical school...
December 2016: Advances in Physiology Education
Lesley Henderson, Simon Carter
There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of 'the doctor' in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of 'the doctor' is discursively deployed to act as the moral compass at the centre of the programme narrative...
September 30, 2016: Medical Humanities
Melissa R Mazan, Gigi Kay, Mohammed Larbi Souhail, Kirstin Bubeck, Thomas Jenei, Jay Merriam
There is an increasing need to produce veterinarians with knowledge and critical thinking skills that will allow them to participate in veterinary global health equity delivery, particularly in the developing world, where many people remain dependent on animal-based agriculture for a living. This need for veterinarians trained in global health is reflected by the demand among students for greater exposure and education. At the same time, many students are held back from on-site training in global health due to constraints of cost, time, or family obligations...
September 30, 2016: Journal of Veterinary Medical Education
Paula Godoy-Ruiz, Jamie Rodas, Yves Talbot, Katherine Rouleau
PURPOSE: In a global context of growing health inequities, international learning experiences have become a popular strategy for equipping health professionals with skills, knowledge, and competencies required to work with the populations they serve. This study sought to analyse the Chilean Interprofessional Programme in Primary Health Care (CIPPHC), a 5 week international learning experience funded by the Ministry of Health in Chile targeted at Chilean primary care providers and delivered in Toronto by the Department of Family and Community Medicine at the University of Toronto...
September 2016: Education for Primary Care
Carole Vuillerot, Mickael Dinomais, Stephane Marret, Stephane Chabrier, Thierry Debillon
Neonatal arterial ischemic stroke (NAIS) affects one child in 6-17 100,000-birth term neonates, most of these children will keep long-term motor and cognitive impairment. In 2014, initiated by the French Center for Pediatric Stroke in association with the French Society of Neonatology, a steering committee was created to propose clinical guidelines after NAIS. From all the relevant questions, the importance is given to long-term outcomes after a NAIS with a need for a better description of motor and cognitive outcomes after a NAIS in order to propose a more consensual monitoring for these children to improve their management...
September 2016: Annals of Physical and Rehabilitation Medicine
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