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https://www.readbyqxmd.com/read/28810977/moving-beyond-accidental-leadership-a-graduate-medical-education-leadership-curriculum-needs-assessment
#1
Joshua D Hartzell, Clifton E Yu, Brian M Cohee, Michael R Nelson, Ramey L Wilson
BACKGROUND: Despite calls for greater physician leadership, few medical schools, and graduate medical education programs provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. Rather, most leaders develop through what has been labeled "accidental leadership." A survey was conducted at Walter Reed to define the current status of leadership development and determine what learners and faculty perceived as key components of a leadership curriculum...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810157/propagating-the-haze-community-and-professional-perceptions-of-cannabis-cultivation-and-the-impacts-of-prohibition
#2
Helen Beckett Wilson, Stuart Taylor, Giles Barrett, Janet Jamieson, Lauren Grindrod
BACKGROUND: Recent decades have seen substantial changes in the UK cannabis landscape, including increased domestic production, the ascendancy of stronger strains (namely 'skunk') and the drug's reclassification under the 1971 Misuse of Drugs Act. Resultantly, cannabis retains significance in the consciousness, priorities and policy agendas of communities, drug services and criminal justice agencies. METHODS: This paper presents an empirical study, which examined both perceptions and impacts of cannabis cultivation and its control within a North-West English borough...
August 12, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28805416/identifying-barriers-to-culture-change-a-qualitative-analysis-of-the-obstacles-to-delivering-resident-centered-care
#3
Ryann L Engle, Denise A Tyler, Katelyn E Gormley, Melissa K Afable, Kimberly Curyto, Omonyêlé L Adjognon, Victoria A Parker, Jennifer L Sullivan
A growing number of healthcare organizations have moved from traditional, institutional nursing home models to ones that emphasize culture change, or resident-centered care (RCC). In 2006, the Department of Veterans Affairs (VA) began implementing a number of changes to VA nursing homes, now called Community Living Centers (CLCs), to provide veterans with a more resident-centered and homelike environment. This study aimed to understand the barriers CLC staff face when delivering RCC. Ten CLCs were included on the basis of their performance levels on RCC and quality of care...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28794617/sociodemographic-profile-and-predictors-of-outpatient-clinic-attendance-among-hiv-positive-patients-initiating-antiretroviral-therapy-in-selangor-malaysia
#4
Surajudeen Abiola Abdulrahman, Lekhraj Rampal, Norlijah Othman, Faisal Ibrahim, Kadir Shahar Hayati, Anuradha P Radhakrishnan
BACKGROUND: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia. PATIENTS AND METHODS: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28791680/immigrant-reproductive-dysfunction-facilitates-ecological-speciation
#5
Ola Svensson, Johanna Gräns, Malin C Celander, Jonathan Havenhand, Erica H Leder, Kai Lindström, Sofie Schöld, Cock van Oosterhout, Charlotta Kvarnemo
The distributions of species are not only determined by where they can survive - they must also be able to reproduce. Although immigrant inviability is a well-established concept, the fact that immigrants also need to be able to effectively reproduce in foreign environments has not been fully appreciated in the study of adaptive divergence and speciation. Fertilization and reproduction are sensitive life history stages that could be detrimentally affected for immigrants in non-native habitats. We propose that 'immigrant reproductive dysfunction' is a hitherto overlooked aspect of reproductive isolation caused by natural selection on immigrants...
August 9, 2017: Evolution; International Journal of Organic Evolution
https://www.readbyqxmd.com/read/28791292/the-role-of-supplemental-complex-dietary-carbohydrates-and-gut-microbiota-in-promoting-cardiometabolic-and-immunological-health-in-obesity-lessons-from-healthy-non-obese-individuals
#6
REVIEW
Petra C Vinke, Sahar El Aidy, Gertjan van Dijk
Dietary supplementation with complex carbohydrates is known to alter the composition of gut microbiota, and optimal implementation of the use of these so called "prebiotics" could be of great potential in prevention and possibly treatment of obesity and associated cardiometabolic and inflammatory diseases via changes in the gut microbiota. An alternative to this "microbiocentric view" is the idea that health-promoting effects of certain complex carbohydrates reside in the host, and could secondarily affect the diversity and abundance of gut microbiota...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28782193/resident-responses-to-after-hours-otolaryngology-patient-phone-calls-an-overlooked-aspect-of-residency-training
#7
Ashton E Lehmann, Elliott D Kozin, Rosh K V Sethi, Kevin Wong, Brian M Lin, Stacey T Gray, Michael J Cunningham
OBJECTIVES/HYPOTHESIS: Otolaryngology residents are often responsible for triaging after-hours patient calls. However, residents receive little training on this topic. Data are limited on the clinical content, reporting, and management of otolaryngology patient calls. This study aimed to characterize the patient concerns residents handle by phone and their subsequent management and reporting. STUDY DESIGN: Retrospective review. METHODS: Five hundred consecutive after-hours patient calls in a tertiary pediatric hospital were reviewed...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28781134/psychological-effect-of-a-mass-casualty-event-on-general-surgery-residents
#8
William S Havron, Karen Safcsak, Joshua Corsa, Andrew Loudon, Michael L Cheatham
OBJECTIVE: To evaluate the psychological effect of a mass casualty shooting event on general surgery residents. DESIGN: Three and 7 months following the Pulse nightclub mass casualty shooting, the mental well-being of general surgery residents employed at the receiving institution was evaluated. A voluntary and anonymous screening questionnaire for posttraumatic stress disorder (PTSD) and major depression (MD) was administered. Responses were stratified into 2 groups; residents who worked (ON-CALL) and residents who did not work (OFF-CALL) the night of the event...
August 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28777295/soymilk-improves-muscle-weakness-in-young-ovariectomized-female-mice
#9
Yuriko Kitajima, Shizuka Ogawa, Shintaro Egusa, Yusuke Ono
Estrogens play a key role in an extensive range of physiological functions in various types of tissues throughout the body in females. We previously showed that estrogen insufficiency caused muscle weakness that could be rescued by estrogen administration in a young female ovariectomized (OVX) mouse model. However, long-term estrogen replacement therapy increases risks of breast cancer and cardiovascular diseases. Soymilk contains plant-based protein and isoflavones that exert estrogen-like activity. Here we examined the effects of prolonged soymilk intake on muscle and its resident stem cells, called satellite cells, in the estrogen-insufficient model...
August 4, 2017: Nutrients
https://www.readbyqxmd.com/read/28774748/investigation-on-different-chemical-stability-of-mitochondrial-hsp60-and-its-precursor
#10
Caterina Ricci, Rita Carrotta, Giacoma Cinzia Rappa, Maria Rosalia Mangione, Fabio Librizzi, Pier Luigi San Biagio, Heinz Amenitsch, Maria Grazia Ortore, Silvia Vilasi
In the large class of molecules that maintain protein homeostasis, called molecular chaperones, chaperonins constitute a subclass that specifically assist the correct folding of newly synthesized proteins. Among them, Hsp60 is composed of a double heptameric ring structure with a large central cavity where the unfolded protein binds via hydrophobic interactions and is supported, in this function, by the co-chaperonin Hsp10. Hsp60 is typically located in the mitochondria, but in some pathological situations, such as cancers and chronic inflammatory diseases, Hsp60 accumulates in the cytoplasm...
July 26, 2017: Biophysical Chemistry
https://www.readbyqxmd.com/read/28767499/clinician-investigator-training-and-the-need-to-pilot-new-approaches-to-recruiting-and-retaining-this-workforce
#11
Alison K Hall, Sherry L Mills, P Kay Lund
Clinician-investigators, also called physician-scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers...
August 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28762593/influencing-everyday-activities-in-a-nursing-home-setting-a-call-for-ethical-and-responsive-engagement
#12
Margarita Mondaca, Staffan Josephsson, Arlene Katz, Lena Rosenberg
This study focuses on influence that older adults, living in nursing homes, have over everyday activities. Everyday activities are key to sustain a sense of stability, predictability, and enjoyment in the local world of people's everyday and therefore a critical dimension of the person-centeredness framework applied within gerontology. This narrative ethnographic study aimed to shed light on how influence can be situated contextually, and how it can emerge through activities as well as how it is negotiated in everyday by frail older adults living in a nursing home...
August 1, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28753038/physician-experiences-with-high-value-care-in-internal-medicine-residency-mixed-methods-study-of-2003-2013-residency-graduates
#13
Kira L Ryskina, Eric S Holmboe, Judy A Shea, Esther Kim, Judith A Long
Phenomenon: High healthcare costs and relatively poor health outcomes in the United States have led to calls to improve the teaching of high value care (defined as care that balances potential benefits of interventions with their harms including costs) to physicians-in-training. Numerous interventions to increase high value care in graduate medical education were implemented at the national and local levels over the past decade. However, there has been little evaluation of their impact on physician experiences during training and perceived preparedness for practice...
July 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28747343/the-development-of-steady-state-activation-hubs-between-adult-lti-ilc3s-and-primed-macrophages-in-small-intestine
#14
Adam K Savage, Hong-Erh Liang, Richard M Locksley
Group 3 innate lymphoid cells (ILC3s) are important for intestinal health, particularly in controlling inflammation in response to epithelial dysregulation, but their role during homeostasis remains less well understood. We generated IL-22 reporter mice to assess production of this key cytokine by ILC3s in the small intestine during development and under basal conditions. Although IL-22 is produced by a variety of lymphocyte populations, constitutively high IL-22 expression was limited to lymphoid-tissue inducer (LTi) cells residing in lymph node-like structures in the gut called solitary intestinal lymphoid tissues (SILT)...
July 26, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28744881/new-common-program-requirements-for-the-resident-physician-workforce-and-the-omission-of-strategic-napping-a-missed-opportunity
#15
Michelle M Shnayder, Joan E St Onge, Alberto J Caban-Martinez
OBJECTIVES: Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. METHODS: We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations...
July 26, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28741362/gastroenterology-evolution-of-specialty-choice-in-recent-years
#16
José Curbelo, José-María Galván-Román, Fernando Sánchez-Lasheras, Jose María Romeo, Ana Fernández-Somoano, Tomás Villacampa, Jaime Baladrón
INTRODUCTION: Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. MATERIALS AND METHODS: Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization...
July 25, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28738121/incidence-risks-and-types-of-infections-in-pediatric-long-term-care-facilities
#17
Lisa Saiman, Philip Maykowski, Meghan Murray, Bevin Cohen, Natalie Neu, Haomioa Jia, Gordon Hutcheon, Edwin Simpser, Linda Mosiello, Luis Alba, Elaine Larson
Importance: The population of infants, children, and adolescents cared for at pediatric long-term care facilities is increasing in complexity and size and thus consumes substantial health care resources. Infections are a significant cause of morbidity and mortality in this population, but few recent data describe their incidence and effects. Objectives: To describe the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identify risk factors for respiratory tract infections (RTIs)...
July 24, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28733171/are-residents-prepared-for-surgical-cases-implications-in-patient-safety-and-education
#18
Minh-Bao Mundschenk, Elizabeth B Odom, Trina D Ghosh, Grant M Kleiber, Andrew Yee, Kamlesh B Patel, Susan E Mackinnon, Marissa M Tenenbaum, Donald W Buck
OBJECTIVE: In surgical education, the areas of focus and evaluation are skewed toward technical skill and operative knowledge; less emphasized is familiarity with the patient's medical history. The purposes of this study were to characterize how surgical trainees prepare for cases and to determine the comprehensiveness of their preparation. DESIGN: A 27-question survey was created through a web-based software program and distributed to all resident physicians and fellows in the Departments of Surgery, Neurosurgery, and Otolaryngology at our institution...
July 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28722202/medical-residents-circadian-preferences-across-specialties
#19
Anthony L Chin-Quee, Kathleen Yaremchuk
OBJECTIVE: Circadian preference refers to the tendency of individuals to be more alert and effective in the morning (larks) or the evening (owls). Given the rigors of medical residency training and perceived lifestyle differences among specialties, circadian preference may play a role in choice of medical specialty and subsequent job satisfaction during training. This study aimed to determine the circadian preferences of residents across specialties and correlations with specialty choice and job satisfaction...
July 19, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28721899/gaps-in-radiation-therapy-awareness-results-from-an-educational-multi-institutional-survey-of-us-internal-medicine-residents
#20
MULTICENTER STUDY
Narek Shaverdian, Sun Mi Yoo, Ryan Cook, Eric M Chang, Naomi Jiang, Ye Yuan, Kiri Sandler, Michael Steinberg, Percy Lee
PURPOSE: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. METHODS AND MATERIALS: A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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