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https://www.readbyqxmd.com/read/28535318/allopathic-and-osteopathic-medicine-unify-gme-accreditation-a-historic-convergence
#1
Abdul-Kareem H Ahmed, Peter F Schnatz, Eli Y Adashi
In 1968, the American Medical Association resolved to accept qualified graduates of osteopathic medical schools into its accredited Graduate Medical Education (GME) programs. An equally momentous decision was arrived at in 2014 when the Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) resolved to institute a single unified GME accreditation system by July 1, 2020. As envisioned, the unified accreditation system will all but assure system-wide consistency of purpose and practice in anticipation of the Next Accreditation System (NAS) of the ACGME...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28535236/association-between-teaching-status-and-mortality-in-us-hospitals
#2
Laura G Burke, Austin B Frakt, Dhruv Khullar, E John Orav, Ashish K Jha
Importance: Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. Objective: To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions. Design, Setting, and Participants: Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#3
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#4
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530117/combined-impact-of-smoking-and-early-life-exposures-on-adult-lung-function-trajectories
#5
James P Allinson, Rebecca Hardy, Gavin C Donaldson, Seif O Shaheen, Diana Kuh, Jadwiga A Wedzicha
BACKGROUND: Both adverse early life exposures and adult smoking can negatively influence adult lung function trajectory but few studies consider how the impact of early life exposures may be modified by subsequent smoking. METHODS: The Medical Research Council National Survey of Health and Development is a nationally representative cohort, initially of 5362 individuals, followed since enrolment at birth in March 1946. Using data collected prospectively across life and multilevel modelling we investigated how the relationships between early life exposures (infant lower respiratory infection, manual social class, home overcrowding and pollution exposure) and FEV1 and FVC trajectories between ages 43 and 60-64 were influenced by smoking behaviour...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28529194/a-national-cross-sectional-study-of-surgery-residents-who-underreport-duty-hours
#6
Christopher L Bennett, David A McDonald, Yuchiao Chang, Alex Finch, Kimmy Vuong, Stuart Rennie, Eric S Nadel
OBJECTIVE: Previous work demonstrates that many surgery residents underreport duty hours. The purpose of this study was to identify characteristics of these residents and better understand why they exceed duty hours. DESIGN: During the winter of 2015 we conducted an anonymous cross-sectional survey of Accreditation Council for Graduate Medical Education accredited general surgery programs. SETTING: A total of 101 general surgery residency programs across the United States...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28527934/variability-in-2-year-training-programs-in-vascular-surgery-based-on-results-of-an-association-of-program-directors-in-vascular-surgery-survey
#7
Keith D Calligaro, Danielle M Pineda, Sam Tyagi, Hong Zheng, Douglas A Troutman, Matthew J Dougherty
OBJECTIVE: Although a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships. METHODS: We polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527892/outbreak-of-zika-virus-infection-in-singapore-an-epidemiological-entomological-virological-and-clinical-analysis
#8
(no author information available yet)
BACKGROUND: An outbreak of Zika virus infection was detected in Singapore in August, 2016. We report the first comprehensive analysis of a national response to an outbreak of Zika virus infection in Asia. METHODS: In the first phase of the outbreak, patients with suspected Zika virus infection were isolated in two national referral hospitals until their serum tested negative for the virus. Enhanced vector control and community engagement measures were deployed in disease clusters, including stepped-up mosquito larvicide and adulticide use, community participation in source reduction (destruction of mosquito breeding sites), and work with the local media to promote awareness of the outbreak...
May 17, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28527637/the-state-of-shared-decision-making-in-malaysia
#9
Yew Kong Lee, Chirk Jenn Ng
Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527078/our-headache-fellowship-a-10-year-history
#10
Paul Rizzoli
There has been a clear trend in American medical education after World War II toward training specialization and subspecialization. After some early specialization efforts by the American Board of Psychiatry and Neurology, further efforts were undertaken by the United Council for Neurologic Subspecialties (UCNS), leading to the introduction of the neurologic subspecialty of Headache Medicine in March, 2005. The training program at our center at the Brigham and Women's Hospital Department of Neurology, Harvard Medical School, in Boston, Massachusetts, was accredited in 2008 and has graduated 14 trainees since its inception...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28526613/the-role-of-trochanteric-flip-osteotomy-in-fixation-of-certain-acetabular-fractures
#11
Sandeep Gupta, Jagdeep Singh, Jagandeep Singh Virk
PURPOSE: Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures...
March 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28525630/laboratory-integration-and-consolidation-in-a-regional-health-system
#12
Jim Cook
Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment...
May 19, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28525526/critical-analysis-of-the-council-for-international-organizations-of-medical-sciences-2016-international-guidelines-for-health-related-research-involving-humans
#13
REVIEW
Miguel Hugo Kottow Lang
This paper presents a preliminary discussion of the Council for International Organizations of Medical Sciences (CIOMS), recently issued “International Ethical Guidelines for Health-related Research Involving Humans” (2016) that acknowledges the document’s declared concern of the protection of human subjects and awareness of their needs and interests in “low-resource settings”. Nevertheless, guideline recommendations present exceptional situations –vulnerability, mental incompetence- wherein voluntary and consented participation may be reduced or omitted under three concurrent conditions: compelling scientific value, the need to include persons that will not benefit directly from participation, exposure to minimal or slight risks...
May 15, 2017: Medwave
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#14
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28514704/guillain-barr%C3%A3-syndrome-variants-forms-fruste-reclassification-with-new-criteria
#15
Fu Liong Hiew, Rahmansah Ramlan, Shanthi Viswanathan, Santhi Puvanarajah
OBJECTIVES: This study aimed to evaluate the clinical and electrophysiological characteristics of various distinctive classical and localised Guillain-Barré syndrome (GBS) subtypes. PATIENTS AND METHODS: Clinical characteristics and electrophysiological data of sixty-one consecutive patients admitted between 2012 and 2015 were systematically analysed and reclassified according to the new GBS clinical classification. Neurophysiology was evaluated with Hadden et al...
May 4, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28514230/causes-of-death-of-residents-in-acgme-accredited-programs-2000-through-2014-implications-for-the-learning-environment
#16
Nicholas A Yaghmour, Timothy P Brigham, Thomas Richter, Rebecca S Miller, Ingrid Philibert, DeWitt C Baldwin, Thomas J Nasca
PURPOSE: To systematically study the number of U.S. resident deaths from all causes, including suicide. METHOD: The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28512078/is-mci-over-emphasising-publication-for-promotion-of-medical-teachers
#17
Shobhit Jain, Harjeet Jain, Ashok Kumar Jain
Over the past year, there has been constant debate in various journals on the circular issued by the Medical Council of India (MCI) in September 2015, regarding the requirements for promotion of teaching faculty. The lack of a time-bound promotion system of medical faculty results in higher stress, dissatisfaction, lower productivity and quality of life and work. The critics have highlighted several issues in assessment of publication for teacher's promotion, eg the exclusion of publications in "electronic-only" journals, awarding points only to "original research" papers and first or second authors, listing of indexing databases for journals, categorising journals as national or international...
April 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28512040/meningiomas-adjacent-to-major-venous-sinuses-clinical-outcome-and-recurrence
#18
Judith Anthofer, Rahel Seidel-Schulz, Alexander Brawanski, Karl-Michael Schebesch
INTRODUCTION: Surgical treatment of meningiomas next to venous sinuses is difficult because of their irregular growth patterns and infiltration into the venous sinuses, therefore making gross total resection impossible in some patients. In this study, we evaluated the postoperative clinical and neurological course of this tumor subgroup. METHODS: This study included 141 consecutive patients with meningioma located within 20 mm to a major venous sinus. We reviewed patient charts and surgical reports for demographics, histology, and clinical and neurological performance pre- and postoperatively and during follow-up...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28509835/changes-by-the-accreditation-council-for-graduate-medical-education-success-or-failure-an-aoa-critical-issues-symposium
#19
Terry L Thompson, Rick W Wright, Thomas J Nasca
The Accreditation Council for Graduate Medical Education has introduced far-reaching changes to the educational requirements for postgraduate trainees over the past 15 years. These steps were taken to improve the quality of education and to enhance patient safety. This symposium will explore the design and implementation of these changes and determine if they are succeeding.
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28509701/educational-gaps-in-molecular-diagnostics-genomics-and-personalized-medicine-in-dermatopathology-training-a-survey-of-us-dermatopathology-fellowship-program-directors
#20
Kristin Torre, Kristen Russomanno, Tammie Ferringer, Dirk Elston, Michael J Murphy
BACKGROUND: Molecular technologies offer clinicians the tools to provide high-quality, cost-effective patient care. We evaluated education focused on molecular diagnostics, genomics, and personalized medicine in dermatopathology fellowship. DESIGN: A 20-question online survey was emailed to all (n = 53) Accreditation Council for Graduate Medical Education (ACGME)-accredited dermatopathology training programs in the United States. RESULTS: Thirty-one of 53 program directors responded (response rate = 58%)...
May 2, 2017: American Journal of Dermatopathology
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