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https://www.readbyqxmd.com/read/29762792/medical-student-interest-in-flexible-residency-training-options
#1
Madison Piotrowski, Debra Stulberg, Mari Egan
BACKGROUND AND OBJECTIVES: Medical residents continue to experience high rates of burnout during residency training even after implementation of the 2003 Accreditation Council for Graduate Medical Education duty-hour restrictions. The purpose of this study is to determine medical student interest in flexible residency training options. METHODS: Researchers developed an 11-question survey for second through fourth-year medical students. The populations surveyed included medical students who were: (1) attending the 2015 American Academy of Family Physicians National Conference, the 2015 Family Medicine Midwest Conference, and (2) enrolled at University of Chicago Pritzker School of Medicine, University of Illinois College of Medicine at Chicago, Drexel University College of Medicine, and Case Western Reserve University School of Medicine...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29762115/effects-of-accreditation-council-for-graduate-medical-education-duty-hour-regulations-on-clinical-preparedness-of-first-year-orthopaedic-attendings-a-survey-of-senior-orthopaedic-surgeons
#2
Steven T DiSegna, Timothy D Kelley, Deborah M DeMarco, Abhay R Patel
It is unclear how the Accreditation Council for Graduate Medical Education (ACGME) resident duty hour restriction has affected attending orthopaedic surgeons in their first year of practice. The purpose of this study was to compare the clinical preparedness of first-year orthopaedic attending surgeons who trained with ACGME duty hour regulations versus those trained without regulations. Senior orthopaedic surgeons with greater than 10 years of experience were surveyed and results indicate that first-year attendings who trained with ACGME duty hour regulations required more supervision reviewing cases preoperatively, required more assistance completing operative cases, had inferior technical skills, had more major operative complications, had poorer physical exam skills, and delivered an inferior quality of care...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29754078/heavy-duty-diesel-vehicles-dominate-vehicle-emissions-in-a-tunnel-study-in-northern-china
#3
Congbo Song, Chao Ma, Yanjie Zhang, Ting Wang, Lin Wu, Peng Wang, Yan Liu, Qian Li, Jinsheng Zhang, Qili Dai, Chao Zou, Luna Sun, Hongjun Mao
The relative importance of contributions of gasoline vehicles (GVs) and diesel vehicles (DVs), heavy-duty diesel vehicles (HDDVs) and non-HDDVs to on-road vehicle emissions remains unclear. Vehicle emission factors (EFs), including fine particulate matter (PM2.5 ), NO-NO2 -NOx , and carbon monoxide (CO), were measured (August 4-18, 2017) in an urban tunnel in Tianjin, northern China. The average EFs (mg km-1 veh-1 ) of the fleet were as follows: 9.21 (95% confidence interval: 1.60, 23.07) for PM2.5 , 62.08 (21...
May 9, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29741654/assessment-of-muscular-fitness-as-a-predictor-of-flight-duty-limitation
#4
Tuomas Honkanen, Matti Mäntysaari, Janne Avela, Heikki Kyröläinen, Tuomo Leino
Introduction: The high acceleration (Gz) exposure among military pilots flying fighter aircraft has been associated with an increased risk for cervical and lumbar disorders. It has been suggested that an adequate level of physical performance could reduce the risk of experiencing these disorders. The Finnish Air Force has for several years used aerobic (bicycle ergometer) and muscular fitness tests (battery of five tests) in the selection process of military pilot candidates in order to evaluate their physical fitness level...
May 8, 2018: Military Medicine
https://www.readbyqxmd.com/read/29727320/creating-a-quality-improvement-course-for-undergraduate-medical-education-practice-what-you-teach
#5
Tamala S Bradham, Kelly C Sponsler, Scott C Watkins, Jesse M Ehrenfeld
PROBLEM: More than half of U.S. medical schools have implemented curricula addressing quality improvement (QI); however, the evidence on which pedagogical methods are most effective is limited. APPROACH: As of January 2015, students at Vanderbilt University School of Medicine are required to take a QI course consisting of three 1-month-long (4 hours per week) blocks during their third or fourth year, in which student-identified faculty sponsors are paired with highly trained QI professionals from Vanderbilt University Medical Center...
May 2, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29715598/administration-of-oxytocin-during-spontaneous-labour-a-national-vignette-based-study-among-midwives
#6
Johanne Isidore, Anne Rousseau
OBJECTIVE: (1) to assess variations in oxytocin use by midwives during spontaneous labour (indication, dose, moment), and (2) to identify factors potentially associated with oxytocin administration. DESIGN: descriptive cross-sectional study using a case-vignette and questionnaire among French midwives from November 2015 to May 2016. METHODS: Midwives were asked to complete an online survey including a case-vignette with hourly partograms of a slowly progressing labour, and a short self-administered questionnaire...
April 21, 2018: Midwifery
https://www.readbyqxmd.com/read/29704054/restricted-working-hours-in-austrian-residency-programs-survey-results
#7
Konstantin D Bergmeister, Martin Aman, Bruno K Podesser
BACKGROUND: New regulations for working hours of medical doctors have been implemented in Austria based on the European directive 2003/88/EG, limiting on-duty working hours to 58 h per week. Clinical work is, therefore, substantially reduced compared to previous decades, and little is known on physician and students' opinions on this matter. We illustrate survey results concerning on-job training, its difficulties, and implications for restricted working hours. METHODS: We conducted an internal survey among M...
April 27, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29703860/thinking-clearly-about-the-first-trial-addressing-ethical-challenges-in-cluster-randomised-trials-of-policy-interventions-involving-health-providers
#8
Austin R Horn, Charles Weijer, Spencer Phillips Hey, Jamie Brehaut, Dean A Fergusson, Cory E Goldstein, Jeremy Grimshaw, Monica Taljaard
The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the relevant ethical issues...
April 27, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29687753/cleaning-up-the-paper-trail-our-clinical-notes-in-open-view
#9
Gerard Lambe, Niall Linnane, Ian Callanan, Marcus W Butler
Purpose Ireland's physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present. Design/methodology/approach A customised audit tool was created using Sphinx software...
April 16, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29673429/lumbar-disc-herniation-in-military-helicopter-pilots-vs-matched-controls
#10
Jeffrey B Knox, J Banks Deal, Jennifer A Knox
INTRODUCTION: Lumbar disc herniation (LDH) is a common injury among active duty service members resulting in missed duty hours and limited duty status. Little is known about the current burden of disease and risk factors for LDH among military rotary wing aviators. METHODS: A query was made using the Defense Medical Epidemiology Database (DMED), including patient encounters for the U.S. Military from 2006-2015 using the ICD-9 code for LDH. Incidence rates were calculated for patients with the occupation of helicopter pilot and stratified by age, gender, and branch of service, then compared to matched controls using a Poisson regression analysis...
May 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29672401/invited-commentary-on-gender-differences-in-utilization-of-duty-hour-regulations-aspects-of-burnout-and-psychological-well-being-among-general-surgery-residents-in-the-u-s
#11
https://www.readbyqxmd.com/read/29671314/emissions-during-and-real-world-frequency-of-heavy-duty-diesel-particulate-filter-regeneration
#12
Chris Ruehl, Jeremy D Smith, Yilin Ma, Jennifer Erin Shields, Mark Burnitzki, Wayne Sobieralski, Robert Ianni, Donald J Chernich, M-C Oliver Chang, John Francis Collins, Seungju Yoon, David Quiros, Shaohua Hu, Harry Dwyer
Recent tightening of particulate matter (PM) emission standards for heavy-duty engines has spurred the widespread adoption of diesel particulate filters (DPF), which need to be regenerated periodically to remove trapped PM. The total impact of DPFs therefore depends not only on their filtering efficiency during normal operation, but also on the emissions during and the frequency of regeneration events. We performed active (parked and driving) and passive regenerations on two heavy-duty diesel vehicles (HDDVs), and report the chemical composition of emissions during these events, as well as the efficiency with which trapped PM is converted to gas-phase products...
April 19, 2018: Environmental Science & Technology
https://www.readbyqxmd.com/read/29661355/the-structure-of-medical-intensive-care-units-at-training-institutions
#13
Marc Heincelman, Ashley Duckett, Brad Keith, Andrew Schreiner, Jingwen Zhang, Edward Kilb, Benjamin Clyburn
BACKGROUND: As a result of the 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour guideline implementation, the structure of intensive care unit (ICU) teams at training institutions has been affected. The impact these changes have had on the current work environment has not been well described. METHODS: The authors conducted an online survey of internal medicine program directors in 2016. The survey investigated how training institutions structure their intensive care units in reference to volume, resident housestaff and alternative coverage options, with a focus on changes made after the implementation of the 2011 ACGME duty hour restrictions...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29625799/impact-of-stroke-call-on-the-stroke-neurology-workforce-in-the-united-states-possible-challenges-and-opportunities
#14
Edgar J Kenton, Antonio Culebras, Pierre B Fayad, Larry B Goldstein, Brian Kaskie, Enrique C Leira, Helmi L Lutsep, Lawrence R Wechsler, José Biller, Irene L Katzan, James C Stevens, David Z Wang, Nellie Adams, Carolyn Cahill
BACKGROUND: The Stroke & Vascular Neurology Section of the American Academy of Neurology was charged to identify challenges to the recruitment and retention of stroke neurologists and to make recommendations to address any identified problems. The Section initiated this effort by determining the impact of stroke on-call requirements as a barrier to the recruitment and retention of vascular neurologists. METHODS: This is a cross-sectional survey of a sample of US Neurologists providing acute stroke care...
April 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29619354/canadian-plastic-surgery-resident-work-hour-restrictions-practices-and-perceptions-of-residents-and-program-directors
#15
Colin W McInnes, Joshua Vorstenbosch, Ryan Chard, Sarvesh Logsetty, Edward W Buchel, Avinash Islur
Background: The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. Objective: To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety...
February 2018: Plastic Surgery
https://www.readbyqxmd.com/read/29607714/availability-of-dutch-general-practitioners-for-after-hours-palliative-care
#16
Fredrik M Plat, Yvonne A S Peters, Paul Giesen, Marleen Smits
BACKGROUND: Continuity of care is important for palliative patients in their end of life. In the Netherlands, after-hours primary care for palliative patients is either provided by large-scale general practitioner (GP) cooperatives or GPs choose to give palliative care by themselves while they are not on duty. AIM: To examine the availability of, perceived problems by, and attitude of Dutch GPs regarding providing palliative care for their own patients outside office hours...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29578649/assessing-the-impact-of-the-graduate-certificate-in-anatomical-sciences-instruction-a-post-degree-survey
#17
April Richardson-Hatcher, Brian MacPherson, Douglas Gould, Jennifer Brueckner-Collins
There are few graduate programs available for pursuing a doctorate in anatomy where students gain specific training in gross anatomy dissection and the responsibilities of a medical educator. In light of this fact, the University of Kentucky created a Graduate Certificate in Anatomical Sciences Instruction in 2006. This 12-credit hour curriculum includes detailed training in gross anatomy and/or neuroscience courses, practicum experiences, a seminar class in pedagogical literature, and a course in educational strategies for the anatomical sciences...
March 26, 2018: Anatomical Sciences Education
https://www.readbyqxmd.com/read/29578553/trends-in-inpatient-admission-comorbidity-and-electronic-health-data-implications-for-resident-workload-intensity
#18
Amanda V Clark, Charles M LoPresti, Todd I Smith
In the era of duty hour regulations, there is increasing concern regarding resident workload compression. We conducted a retrospective, observational assessment of all internal medicine resident admissions to a Veterans Affairs hospital over a 15-year period to evaluate several admission components that impact resident workload and workload intensity, including electronic health record (EHR) data burden and patient comorbidity. A total of 67,346 admissions were included in the analysis. Mean patient comorbidity, as measured by the Charlson Comorbidity Index, increased throughout the study period...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29562969/equivalence-testing-as-a-tool-for-fatigue-risk-management-in-aviation
#19
Lora J Wu, Philippa H Gander, Margo van den Berg, T Leigh Signal
BACKGROUND: Many civilian aviation regulators favor evidence-based strategies that go beyond hours-of-service approaches for managing fatigue risk. Several countries now allow operations to be flown outside of flight and duty hour limitations, provided airlines demonstrate an alternative method of compliance that yields safety levels "at least equivalent to" the prescriptive regulations. Here we discuss equivalence testing in occupational fatigue risk management. We present suggested ratios/margins of practical equivalence when comparing operations inside and outside of prescriptive regulations for two common aviation safety performance indicators: total in-flight sleep duration and psychomotor vigilance task reaction speed...
April 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29557719/education-outcomes-in-a-duty-hour-flexibility-trial-in-internal-medicine
#20
Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
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