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https://www.readbyqxmd.com/read/28337687/assessing-the-culture-of-residency-using-the-c-change-resident-survey-validity-evidence-in-34-u-s-residency-programs
#1
Linda H Pololi, Arthur T Evans, Janet T Civian, Sandy Shea, Robert T Brennan
BACKGROUND: A practical instrument is needed to reliably measure the clinical learning environment and professionalism for residents. OBJECTIVE: To develop and present evidence of validity of an instrument to assess the culture of residency programs and the clinical learning environment. DESIGN: During 2014-2015, we surveyed residents using the C - Change Resident Survey to assess residents' perceptions of the culture in their programs. PARTICIPANTS: Residents in all years of training in 34 programs in internal medicine, pediatrics, and general surgery in 14 geographically diverse public and private academic health systems...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28337081/a-comprehensive-list-of-items-to-be-included-on-a-pediatric-drug-monograph
#2
Lauren E Kelly, Shinya Ito, David Woods, Anthony J Nunn, Carol Taketomo, Matthijs de Hoog, Martin Offringa
OBJECTIVES: Children require special considerations for drug prescribing. Drug information summarized in a formulary containing drug monographs is essential for safe and effective prescribing. Currently, little is known about the information needs of those who prescribe and administer medicines to children. Our primary objective was to identify a list of important and relevant items to be included in a pediatric drug monograph. METHODS: Following the establishment of an expert steering committee and an environmental scan of adult and pediatric formulary monograph items, 46 participants from 25 countries were invited to complete a 2-round Delphi survey...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28334154/ethical-issues-of-crispr-technology-and-gene-editing-through-the-lens-of-solidarity
#3
John J Mulvihill, Benjamin Capps, Yann Joly, Tamra Lysaght, Hub A E Zwart, Ruth Chadwick
Background: The avalanche of commentaries on CRISPR-Cas9 technology, a bacterial immune system modified to recognize any short DNA sequence, cut it out, and insert a new one, has rekindled hopes for gene therapy and other applications and raised criticisms of engineering genes in future generations. Sources of data: This discussion draws on articles that emphasize ethics, identified partly through PubMed and Google, 2014-2016. Areas of agreement: CRISPR-Cas9 has taken the pace and prospects for genetic discovery and applications to a high level, stoking anticipation for somatic gene engineering to help patients...
February 23, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28323547/the-extent-that-health-professionals-suspect-and-address-addiction-to-medicines-in-primary-care-findings-from-a-survey-in-northwest-england
#4
Geoff Bates, Madeleine Cochrane, Adam John Mackridge
Addiction to medicines available over the counter or via prescription is of growing international concern. The authors of the current article ran an online survey of health professionals in general medical practice and community pharmacy settings in Northwest England to explore the frequency of suspecting and responding to addiction to medicines. Health professionals reported frequently identifying addiction to medicines among patients including those with long-term pain, mental health problems, sleep disorders, and other substance use disorders, but that these addictions often go unchallenged...
March 1, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#5
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28320410/bibliometric-analysis-of-medicine-related-publications-on-refugees-asylum-seekers-and-internally-displaced-people-2000-2015
#6
Waleed M Sweileh
BACKGROUND: Wars and violent domestic conflicts have forced millions of people to move outside their homes. Meeting the basic health needs of those people requires an understanding of research activity and research output on this topic. The objective of this study was to shed light on the quantity and impact of medicine - related publications on refugees, asylum seekers and internally displaced people (IDP). METHOD: Scopus database was used to retrieve required data...
March 20, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28302612/difficult-lumbar-puncture-pitfalls-and-tips-from-the-trenches
#7
REVIEW
P A Hudgins, A J Fountain, P R Chapman, L M Shah
Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28295575/definition-and-assessment-of-disability-in-mental-disorders-under-the-perspective-of-the-international-classification-of-functioning-disability-and-health-icf
#8
Michael Linden
This article provides an overview of definitions and assessment instruments of disability, an important topic in the diagnosis and treatment of chronic illnesses, and in expert appraisals in social and forensic medicine. Health problems are manifested not only in symptoms, but also regularly in impairment or disability in everyday life, which is especially true for mental disorders. According to the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization, disability can be understood as chronic suffering from symptoms of illness, or limitations of executing capacities, or inability to participate in selected areas of life...
March 14, 2017: Behavioral Sciences & the Law
https://www.readbyqxmd.com/read/28295448/drug-rechallenge-following-drug-induced-liver-injury
#9
REVIEW
Christine M Hunt, Julie I Papay, Vid Stanulovic, Arie Regev
Drug induced hepatocellular injury is identified internationally by ALT 5x upper limits normal (ULN) appearing within 3 months of drug initiation, after alternative causes are excluded. Upon withdrawing the suspect drug, ALT generally decreases by 50% or more. With drug readministration, a positive rechallenge has recently been defined by an ALT 3-5xULN or greater. Nearly 50 drugs are associated with positive rechallenge after drug-induced liver injury (DILI): antimicrobials, central nervous system, cardiovascular and oncology therapeutics...
March 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28293671/pilot-phase-evaluation-of-the-elective-general-practice-class-results-of-student-surveys-of-the-first-two-years
#10
Franziska-Antonia Samos, Marcus Heise, Stephan Fuchs, Susanne Mittmann, Alexander Bauer, Andreas Klement
Background: Primary health care in rural regions is currently undergoing a global crisis in respect of the next generation of practitioners. National and international recommendations advise placing greater emphasis upon practical skills and competences in medical studies. It is also in the interest of training the next generation to include mentoring and longitudinal integration of contact to teaching practices for general medicine in an early stage. Consequently, the General Practice Class (KAM) was introduced in Halle in 2011 as an elective with 20 individually mentored students per year, beginning with the first subject-related semester...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#11
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28288456/from-technique-of-tattooing-to-biokinetics-and-toxicology-of-injected-tattoo-ink-particles-and-chemicals
#12
Jørgen Serup
Tattoo colourants are colourful nano- and microparticles, which are practically insoluble and thus permanent once installed in the dermis by the tattooist. Tattoo ink also has soluble ingredients and contaminants. Pigments can distribute via the lymph and possibly also directly to the blood, and a minute fraction may over time undergo metabolic breakdown and as hapten(s) induce allergic reactions of red tattoos. Carbon black of black tattoos has a tendency to agglomerate and form larger bodies that can elicit foreign body reactions in black tattoos and even granuloma formation with overlap to sarcoidosis in the clinic...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28287827/intensive-care-unit-educators-a-multicenter-evaluation-of-behaviors-residents-value-in-attendings
#13
Lekshmi Santhosh, Snigdha Jain, Anna Brady, Michelle Sharp, W Graham Carlos
RATIONALE: It is important for attendings to know which behaviors influence learner perceptions. To date, two studies focusing on general medicine attendings have been published addressing internal medicine residents' perceptions of attendings; there are no data on intensive care unit (ICU) attendings. OBJECTIVES: We sought to expand the evidence regarding this topic through a multicenter study at four geographically diverse academic medical centers. Our study focused on identifying the teaching behaviors of ICU physicians that learners observe in attendings they value as effective educators...
March 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28276672/current-adoption-of-lung-ultrasound-in-intensive-care-units-an-italian-multi-centre-survey
#14
Italo Calamai, Massimiliano Greco, Guido Bertolini, Rosario Spina
BACKGROUND: Lung ultrasound (LUS) is a useful tool for assessing lung status in critically ill patients, but is not widely applied in intensive care units (ICUs). The aim of this study was to investigate the use of LUS in Italian ICUs. METHODS: A questionnaire was distributed to 116 ICU representatives belonging to the Italian GiViTI network, participating in a national project on continuous quality of care assessment. The answers to the questionnaire were analysed with the data collected in the course of said project...
March 7, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28276281/in-vitro-susceptibility-and-resistance-phenotypes-in-contemporary-citrobacter-isolates-in-a-university-hospital-in-crete-greece
#15
Sofia Maraki, Konstantinos Z Vardakas, Viktoria-Eirini Mavromanolaki, Margarita Kyriakidou, George Spais, Diamantis P Kofteridis, George Samonis, Matthew E Falagas
BACKGROUND: Data on Citrobacter spp. susceptibility are scarce. We sought to study the evolution in the susceptibility of 385 Citrobacter spp. at the University Hospital of Heraklion, Crete, Greece during a six-year period (2010-2015). METHODS: Non-duplicate strains isolated from inpatients (intensive care unit, oncology, surgery, internal medicine, paediatrics) and outpatients were studied using Vitek 2. Phenotypic confirmatory tests were applied for detection of β-lactamases and aminoglycoside modifying enzymes...
March 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28266062/k-t-accelerated-aortic-4d-flow-mri-in-under-two-minutes-feasibility-and-impact-of-resolution-k-space-sampling-patterns-and-respiratory-navigator-gating-on-hemodynamic-measurements
#16
Emilie Bollache, Alex J Barker, Ryan Scott Dolan, James C Carr, Pim van Ooij, Rouzbeh Ahmadian, Alex Powell, Jeremy D Collins, Julia Geiger, Michael Markl
PURPOSE: To assess the performance of highly accelerated free-breathing aortic four-dimensional (4D) flow MRI acquired in under 2 minutes compared to conventional respiratory gated 4D flow. METHODS: Eight k-t accelerated nongated 4D flow MRI (parallel MRI with extended and averaged generalized autocalibrating partially parallel acquisition kernels [PEAK GRAPPA], R = 5, TRes = 67.2 ms) using four ky -kz Cartesian sampling patterns (linear, center-out, out-center-out, random) and two spatial resolutions (SRes1 = 3...
March 7, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28265176/development-of-education-program-for-physical-therapy-assistant-in-quang-tri-province-of-vietnam
#17
Jin Won Noh, Sang Hyun Cho, Min Hee Kim, Eun Joo Kim
[Purpose] The purpose of the present study was to develop an education program for physical therapy assistants in order to provide high quality physical therapy for the province of Quang Tri in Vietnam. [Subjects and Methods] Subjects consisted of 9 professors in Quang Tri medical college and 1 physical therapist in Quang Tri General hospital. The survey research to lecturer for education of physical therapy assistant in Quang Tri medical college was conducted as pre-analysis of demand for the physical therapy assistant curriculum development...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28261904/high-resolution-in-vivo-diffusion-imaging-of-the-human-brain-with-generalized-slice-dithered-enhanced-resolution-simultaneous-multislice-gslider-sms
#18
Kawin Setsompop, Qiuyun Fan, Jason Stockmann, Berkin Bilgic, Susie Huang, Stephen F Cauley, Aapo Nummenmaa, Fuyixue Wang, Yogesh Rathi, Thomas Witzel, Lawrence L Wald
PURPOSE: To develop an efficient acquisition for high-resolution diffusion imaging and allow in vivo whole-brain acquisitions at 600- to 700-μm isotropic resolution. METHODS: We combine blipped-controlled aliasing in parallel imaging simultaneous multislice (SMS) with a novel slab radiofrequency (RF) encoding gSlider (generalized slice-dithered enhanced resolution) to form a signal-to-noise ratio-efficient volumetric simultaneous multislab acquisition. Here, multiple thin slabs are acquired simultaneously with controlled aliasing, and unaliased with parallel imaging...
March 5, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28261395/fourth-year-medical-school-course-load-and-success-as-a-medical-intern
#19
Christopher J Richards, Kenneth J Mukamal, Nikki DeMelo, C Christopher Smith
BACKGROUND : The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished. OBJECTIVE : To assess the relationship between fourth-year course load and success during internship. METHODS : We reviewed transcripts of 78 internal medicine interns from 2011-2013 and compared the number of intensive courses (defined as subinternships, intensive care, surgical clerkships, and emergency medicine rotations) with multi-source performance evaluations from the internship...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28257447/exploratory-analysis-of-the-french-version-of-the-beliefs-about-medicines-questionnaire-in-patients-with-severe-mental-disorders-factorial-structure-and-reliability-in-specific-populations-of-schizophrenic-bipolar-and-depressive-patients
#20
Ludovic Samalin, Ingrid de Chazeron, Raoul Belzeaux, Pierre-Michel Llorca
OBJECTIVES: The aims of our study were to explore the factor structure and psychometric properties of the French version of the Beliefs about Medicines Questionnaire (BMQ) in patients with severe mental illness and in specific populations of patients with schizophrenia, bipolar disorder and major depressive disorder. METHODS: A cross-sectional study including patients with schizophrenia, bipolar disorder and major depressive disorder was conducted (n = 150). Principal component analysis (PCA), reliability and validity of the French version of the BMQ were performed...
2017: PloS One
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