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Sara Whetstone, Meg Autry
An unprecedented number of medical students and residents express the desire to participate in global health work during their training and beyond. Preparing learners for work in underserved settings makes it more likely that they will continue to work in areas of need. Training programs that focus on global health have been criticized as there is ample work to be done in the US, and often global health work becomes learner-centric, which is difficult to maintain and potentially burdensome and harmful to the host site...
March 1, 2018: AMA Journal of Ethics
Ronit Koren, Yifat Wiener, Karen Or, Carlos A Benbassat, Shlomit Koren
OBJECTIVES: To study the current practices in the management of subclinical hypothyroidism (SCH) and thyroid nodules during pregnancy of obstetricians/gynecologists (OB/GYNs) and endocrinologists in Israel. METHODS: An electronic questionnaire was sent by email to all members of the Israeli Endocrine Society and the Israel Society of Obstetrics and Gynecology. Questionnaires included demographic data and clinical scenarios with questions regarding the screening and management of pregnant women with SCH, hypothyroxinemia, and a palpable thyroid nodule...
March 2018: Israel Medical Association Journal: IMAJ
Eva M Luo, Henry S Opare-Ado, Joseph Adomako, Kwabena A Danso, Talya Peltzman, Frank W J Anderson
Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives...
March 8, 2018: Maternal and Child Health Journal
Michael F Fialkow, Carrie M Snead, Jay Schulkin
Introduction: As the US health-care system has evolved over the past decade, access to obstetric care in rural communities has declined, and there has been a challenge in retaining obstetrics and gynecology (OB-GYN) providers to train the next generation of physicians. The current pilot study sought to identify the factors that influence faculty who train medical students within the field of OB-GYN with the hope of influencing recruitment and retention of providers for the future. Methods: Clinical OB-GYN faculty within the University of Washington School of Medicine regional medical education program were surveyed about practice patterns and beliefs regarding medical student training as part of a pilot study on provider recruitment and retention...
January 2018: Health Services Research and Managerial Epidemiology
Susan A Barr, Catrina C Crisp, Amanda B White, Shazia A Malik, Kimberly Kenton
OBJECTIVE: The aims of this study are to identify screening, treatment, and referral practices of primary care physicians (PCPs) for patients with pelvic floor disorders (PFDs) and evaluate awareness of the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialty. METHODS: We conducted a cross-sectional survey of PCPs using a random sample of 1005 American College of Physicians members, stratified by demographic region. Electronic survey content included awareness of FPMRS certification, comfort diagnosing and treating PFDs, and PFD referral patterns for PCPs...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
AnnaMarie Connolly, Alice Goepfert, Anita Blanchard, Elizabeth Buys, Nicole Donnellan, Cindy L Amundsen, Shelley L Galvin, Kimberly Kenton
Background : Few tools currently exist for effective, accessible delivery of real-time, workplace feedback in the clinical setting. Objective : We developed and implemented a real-time, web-based tool for performance-based feedback in the clinical environment. Methods : The tool (myTIPreport) was designed for performance-based feedback to learners on the Accreditation Council for Graduate Medical Education (ACGME) Milestones and procedural skills...
February 2018: Journal of Graduate Medical Education
Layan Alrahmani, Elisabeth Codsi, Kristi S Borowski
OBJECTIVES: We evaluated the current state of ultrasound training in obstetrics and gynecology (OB-GYN) residency programs across the United States. METHODS: An electronic survey was sent to OB-GYN residency program directors and OB-GYN residents. Responses were obtained in September 2016. Program directors and residents were asked to reflect on their current ultrasound curriculum. RESULTS: A total of 93 program directors and 437 residents responded...
February 21, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Attila Bokor, Peter Lukovich, Noemi Csibi, Thomas D'Hooghe, Dan Lebovic, Reka Brubel, Janos Rigo
STUDY OBJECTIVE We first present a detailed description of a modified NOSE-colectomy technique. Secondly, we report the postoperative outcomes of our prospective case series when compared to conventional laparoscopic bowel resection in a relatively large series of patients. DESIGN Canadian Task Force Classification II-1. SETTING University tertiary referral center. PATIENTS Patient selection The last 90 consecutive patients in our care with DIE of the bowel are presented in this study. Patients were diagnosed at the 1st Department of OB/GYN Semmelweis Universtiy Budapest, Hungary...
February 14, 2018: Journal of Minimally Invasive Gynecology
Christopher C DeStephano, Anita H Chen, Michael Heckman, Nicolette T Chimato, Paulami Guha, Mariana Espinal, Tri A Dinh
OBJECTIVE: Demonstrate the process for establishing or refuting validity for the Limbs and Things hysterectomy model. DESIGN: Prospective study using Kane's framework for establishing validity (Canadian Task Force Classification: II-2). SETTING: Laparoscopic hysterectomy (TLH) assessments completed in the operating room (OR) and simulation at three academic medical centers. PARTICIPANTS: OB/GYN residents (n=26 post-graduate year 3-4), a gynecologic oncology fellow (post-graduate year 5), and a gynecology oncology attending...
February 9, 2018: Journal of Minimally Invasive Gynecology
Christina Terrazas, Lisa S Segre, Cheryl Wolfe
In 2015, the American College of Obstetricians and Gynecologists issued a recommendation to screen women for depression and anxiety symptoms at least once during the perinatal period. Nevertheless, many identified women will not receive care from a behavioral health specialist. Listening Visits (LV), developed for delivery by nurses and validated in the United Kingdom, have recently been evaluated in a US-based randomized controlled trial (RCT) which recruited research participants from three home-visiting programs and an urban OB/GYN practice...
February 12, 2018: Primary Health Care Research & Development
Lori R Berkowitz, Kaitlyn James, Emil Petrusa, Carey York-Best, Anjali J Kaimal
OBJECTIVE: To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. DESIGN: After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH...
February 5, 2018: Journal of Surgical Education
Gary Fruhman, Collin Miller, Erol Amon, Darbey Raible, Rachael Bradshaw, Kimberly Martin
OBJECTIVE: To examine whether obstetricians think that cardiac surgery is ethical in babies with common aneuploidies and whether insurance companies should be required to pay for these surgeries. STUDY DESIGN: A survey was e-mailed to 2,897 OB-GYNs and 898 (31%) actively practicing obstetricians responded to the survey. Respondents were asked whether it is ethical to offer cardiac surgery for babies with heart defects diagnosed with trisomies 21, 18, 13, and Turner Syndrome and whether insurance companies should be required to pay for such surgeries in cases of trisomy 18 or 13...
February 7, 2018: Prenatal Diagnosis
Jun Li, Qin Zhu, Bingyi Yang, Chengcheng Ning, Xiaoxia Liu, Xuezhen Luo, Xiaojun Chen
OBJECTIVE: This study aimed to investigate the incidence of ovarian malignant involvement in young and premenopausal endometrioid endometrial cancer and study the possible risk factors. METHODS: Premenopausal patients 45 years of age or younger with endometrioid endometrial cancer treated at the OB/GYN Hospital of Fudan University between 2009 and 2013 were identified. The incidence of ovarian malignant involvement in young and premenopausal endometrioid endometrial cancer patients were calculated and the possible risk factors were investigated...
January 31, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Wilson V Chan, Jo-Ann Johnson, R Douglas Wilson, Amy Metcalfe
BACKGROUND: Cell-free DNA (cfDNA) screening has recently acquired tremendous attention, promising patients and healthcare providers a more accurate prenatal screen for aneuploidy than other current screening modalities. It is unclear how much knowledge regarding cfDNA screening obstetrical providers possess which has important implications for the quality and content of the informed consent patients receive. METHODS: A survey was designed to assess obstetrical provider knowledge and attitudes towards cfDNA screening and distributed online through the Society of Obstetricians & Gynecologists of Canada (SOGC)...
January 23, 2018: BMC Pregnancy and Childbirth
Ivan Fistonić, Nikola Fistonić
BACKGROUND AND OBJECTIVE: A growing body of evidence indicates that a non-invasive erbium yttrium-aluminum-garnet (Er:YAG) laser may be an effective and highly tolerable treatment for stress urinary incontinence (SUI) in women. The primary objective was to identify pre-intervention predictors of short-term Er:YAG outcomes. The secondary objective was to identify patient segments with the best Er:YAG laser treatment short-term outcomes. METHODS: A prospective cohort study performed in 2016 at Ob/Gyn Clinic, Zagreb, Croatia, recruited 85 female patients who suffered from SUI...
January 23, 2018: Lasers in Surgery and Medicine
Daniela Grieco, Nicola Lacetera, Mario Macis, Daniela Di Martino
Umbilical cord blood is a source of hematopoietic stem cells essential to treat life-threatening diseases, such as leukemia and lymphoma. However, only a very small percentage of parents donate upon delivery. The decision to donate the cord blood occurs at a very specific time and when parents likely experience emotional, informational, and decisional overloads; these features of cord blood donation make it different from other pro-social activities. In collaboration with an OB-GYN clinic in Milan, Italy, we conducted the first randomized controlled trial that applies tools from behavioral science to foster cord blood donation, and quantified the gains that informational and behavioral "nudges" can achieve...
January 10, 2018: Scientific Reports
Jessica C Arluck, Allison C Mayhew
Preconception counseling is an important aspect of the care of reproductive-aged women. Asking each woman with each interaction her wishes regarding pregnancy allows the health care provider to investigate her history. The areas to review include environmental toxins, nutrition, genetics, substance abuse, medical conditions, infectious diseases, and psychosocial issues. Then preconception counseling can be individualized. The goal is to decrease or eliminate risks that can cause detriments to the patient or her future pregnancies...
March 2018: Clinical Obstetrics and Gynecology
Koji Hara, Susumu Kunisawa, Noriko Sasaki, Yuichi Imanaka
OBJECTIVES: In this longitudinal study, we examined changes in the geographical distribution of physicians in Japan from 2000 to 2014 by clinical specialty with adjustments for healthcare demand based on population structure. METHODS: The Japanese population was adjusted for healthcare demand using health expenditure per capita stratified by age and sex. The numbers of physicians per 100 000 demand-adjusted population (DAP) in 2000 and 2014 were calculated for subprefectural regions known as secondary medical areas...
January 8, 2018: BMJ Open
Paula M Frew, Laura A Randall, Fauzia Malik, Rupali Lamaye, Andrew Wilson, Sean T O'Leary, Daniel Salmon, Meghan Donnelly, Kevin Ault, Matthew Z Dudley, Vincent L Fenimore, Saad B Omer
Pregnancy is an ideal time to communicate with women about vaccines for themselves and their infants, yet maternal immunization rates remain suboptimal. This study aimed to identify clinic, provider, and staff-related attributes and facilitators to be utilized for a comprehensive vaccine intervention in ob-gyn clinical settings. We conducted in-depth interviews with 24 providers, both healthcare providers (e.g., physicians, nurse practitioners, midwives) and practice managers, from urban and suburban ob-gyn practices in Georgia and Colorado about their immunization attitudes, practices, and patient experiences...
January 9, 2018: Human Vaccines & Immunotherapeutics
Zhenghong Ren, Peige Song, Xinlei Chang, Jiawen Wang, Lin An
BACKGROUND: Women's health is defined as a continuum throughout their whole lives. In China, women receive life-round preventative and curative health care from the health system, although the universal access to reproductive health has already been basically achieved in China, the situation of women's access to curative health care is still unknown. METHODS: Data from the national maternal and child health human resource investigation were analysed. Lorenz curves, Gini coefficients, and Theil L indexes were drawn and calculated to reflect the inequality...
January 5, 2018: International Journal for Equity in Health
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