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https://www.readbyqxmd.com/read/29325520/factors-associated-with-low-patient-satisfaction-in-out-of-hours-primary-care-in-denmark-a-population-based-cross-sectional-study
#1
Mette Tranberg, Peter Vedsted, Bodil Hammer Bech, Morten Bondo Christensen, Søren Birkeland, Grete Moth
BACKGROUND: Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction. METHODS: The study was based on data from a 1-year population-based survey of OOH-PC (LV-KOS) in the Central Denmark Region in 2010-2011...
January 11, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29324069/evidence-based-guidelines-for-fatigue-risk-management-in-emergency-medical-services
#2
P Daniel Patterson, J Stephen Higgins, Hans P A Van Dongen, Daniel J Buysse, Ronald W Thackery, Douglas F Kupas, David S Becker, Bradley E Dean, George H Lindbeck, Francis X Guyette, Josef H Penner, John M Violanti, Eddy S Lang, Christian Martin-Gill
BACKGROUND: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an evidence-based guideline for fatigue risk management tailored to EMS operations. METHODS: Systematic searches were conducted from 1980 to September 2016 and guided by seven research questions framed in the Population, Intervention, Comparison, Outcome (PICO) framework...
January 11, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29299519/expeditious-emergency-room-referral-pathway-improves-patient-access-to-otolaryngology-care
#3
Jeffrey Johnson, Zi Yang Jiang, Daniel Martinez, David Smith, Elizabeth Curtis, David Robinson, Ibrahim Alava
Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29290595/the-media-response-to-the-acgme-s-2017-relaxed-resident-duty-hour-restrictions
#4
Zi Zhang, Alan V Krauthamer, Andrew B Rosenkrantz
PURPOSE: In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. METHODS: Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement...
December 28, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29288602/the-types-and-management-of-dental-trauma-during-military-service-in-finland
#5
Atte Antikainen, Pertti Patinen, Jari Päkkilä, Leo Tjäderhane, Vuokko Anttonen
All Finnish males must attend compulsory military service that lasts from six months to one year. About 25 000 males (approximately 80% of each age cohort) and 400 volunteer females complete the service annually. The aim of the study was to investigate the types of dental trauma occurring among Finnish conscripts during their military service. The article also focused on how dental traumas is are treated in the Finnish Defence Forces MATERIAL AND METHODS: All dental records in the Defence Forces' patient register concerning dental trauma during the years 2011 and 2012 were analysed by tooth number, treatment procedures and number of visits RESULTS: According to the patient register, 361 conscripts suffered an oral trauma during their military service; thus, the average annual incidence was 7...
December 30, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/29286272/landmark-lecture-on-surgery-paediatric-cardiothoracic-surgery-training-the-next-generation-of-congenital-heart-surgeons
#6
Vaughn A Starnes, Maura E Sullivan
Introduction Recent changes in surgical education have had an impact on our congenital training programmes. The mandate of the 8-hour workweek, a rapidly expanding knowledge base, and a host of other mandates has had an impact on the readiness of the fellows who are entering congenital programmes. To understand these issues completely, we interviewed the top congenital experts in the United States of America. The purpose of this paper is to share their insight and offer suggestions to address these challenges...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29273338/increased-academic-productivity-of-orthopaedic-surgery-residents-following-2011-duty-hour-reform
#7
Joey P Johnson, Kevin Savage, Joseph A Gil, Craig P Eberson, Mary K Mulcahey
BACKGROUND: In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. DESIGN: Pubmed was queried using publicly available alumni lists from programs across the United States...
December 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29259040/small-ca2-releases-enable-hour-long-high-frequency-contractions-in-midshipman-swimbladder-muscle
#8
Frank E Nelson, Stephen Hollingworth, James O Marx, Stephen M Baylor, Lawrence C Rome
Type I males of the Pacific midshipman fish (Porichthys notatus) vibrate their swimbladder to generate mating calls, or "hums," that attract females to their nests. In contrast to the intermittent calls produced by male Atlantic toadfish (Opsanus tau), which occur with a duty cycle (calling time divided by total time) of only 3-8%, midshipman can call continuously for up to an hour. With 100% duty cycles and frequencies of 50-100 Hz (15°C), the superfast muscle fibers that surround the midshipman swimbladder may contract and relax as many as 360,000 times in 1 h...
December 19, 2017: Journal of General Physiology
https://www.readbyqxmd.com/read/29249232/an-integrated-pathology-and-ultrasonography-based-simulation-for-training-in-performing-kidney-biopsy%C3%A2
#9
Shree G Sharma, John M Arthur, Stephen M Bonsib, Kevin D Phelan, Manisha Singh, Nithin Karakala, Kelly W Bulloch, Vandana Dua Niyyar, Juan Carlos Q Velez
BACKGROUND: Medical practice trends and limitations in trainees' duty hours have diminished the interest and exposure of nephrology fellows to percutaneous kidney biopsy (PKB). We hypothesized that an integrated nephrology-pathology-led simulation may be an effective educational tool. MATERIALS AND METHODS: A 4-hour PKB simulation workshop (KBSW), led by two ultrasonography (US)-trained nephrologists and two nephropathologists, consisted of 6 stations: 1) diagnostic kidney US with live patients, 2) kidney pathology with plasticine models of embedded torso cross-sections, 3) US-based PKB with mannequin (Blue Phantom™), 4) kidney pathology with dissected cadavers, 5) US-based PKB in lightly-embalmed cadavers, and 6) tissue retrieval adequacy examination by microscope...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29244754/evaluation-of-traffic-density-parameters-as-an-indicator-of-vehicle-emission-related-near-road-air-pollution-a-case-study-with-nexus-measurement-data-on-black-carbon
#10
Shi V Liu, Fu-Lin Chen, Jianping Xue
An important factor in evaluating health risk of near-road air pollution is to accurately estimate the traffic-related vehicle emission of air pollutants. Inclusion of traffic parameters such as road length/area, distance to roads, and traffic volume/intensity into models such as land use regression (LUR) models has improved exposure estimation. To better understand the relationship between vehicle emissions and near-road air pollution, we evaluated three traffic density-based indices: Major-Road Density (MRD), All-Traffic Density (ATD) and Heavy-Traffic Density (HTD) which represent the proportions of major roads, major road with annual average daily traffic (AADT), and major road with commercial annual average daily traffic (CAADT) in a buffered area, respectively...
December 15, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29243461/physicians-working-conditions-health-and-working-capacity
#11
Marko Elovainio, Marianna Virtanen, Tuula Oksanen
Changes in the working environment will also influence the work of physicians. The greatest of these changes on the Finnish scale, the SOTE reform (the reform in social welfare and public health services), still lies ahead. Labor shortage, on-call duties and patient record systems providing little support to work add to the burden. In surveys related to psychosocial working conditions, physicians' greatest work load factors have been rush, forced working pace and poor communication despite the fact that, on average, they consider their working conditions to be good, frequently better than those of other professional groups, and are committed to carry on with their work until retirement age...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29239294/demographics-interests-and-quality-of-life-of-canadian-neurosurgery-residents
#12
Christian Iorio-Morin, Syed Uzair Ahmed, Mark Bigder, Ayoub Dakson, Cameron Elliott, Daipayan Guha, Michelle Kameda-Smith, Pascal Lavergne, Serge Makarenko, Michael S Taccone, Michael K Tso, Bill Wang, Alexander Winkler-Schwartz, David Fortin
BACKGROUND: Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents. METHODS: A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016...
December 14, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29224796/residents-impressions-of-the-impact-of-advanced-practice-providers-on-surgical-training
#13
Ravinder Kang, Jesse A Columbo, Samuel T Kunkel, Ryland S Stucke, Matthew J Sabatino, Austin Tang, Philip P Goodney, Kari M Rosenkranz
BACKGROUND: To ensure that residents are appropriately trained in the era of the 80-hour work-week, training programs have restructured resident duties and hired advanced practice providers (APPs). However, the effect of APPs on surgical training remains unknown. STUDY DESIGN: We created a survey using a modified Delphi technique to examine the interaction between residents and APPs across practice settings (inpatient, outpatient, and operating room (OR)). We identified four domains: administrative tasks, clinical experience, operative experience, and overall impressions...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29210132/community-pharmacists-in-england-s-opinions-on-skill-mix-and-delegation
#14
Emma Barnes, Alison Bullock, Margaret Allan, Karen Hodson
OBJECTIVES: Following the 2005 contractual framework amendment, the expanding role of community pharmacy team members required a shift in entrenched views on roles and duties. This study aimed to report on community pharmacists' opinions on skill mix and explore how they can be addressed so that skill mix may be optimised. METHODS: An invitation to complete an online questionnaire was distributed via email, marked for the attention of the lead pharmacist. Following a low response, a paper-based questionnaire was sent to all community pharmacies in England (n = 11,816)...
December 6, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29209996/understanding-ownership-of-patient-care-a%C3%A2-dual-site-qualitative-study-of-faculty-and-residents-from-medicine-and-psychiatry
#15
Deborah S Cowley, Jesse D Markman, Jennifer A Best, Erica L Greenberg, Michael J Grodesky, Suzanne B Murray, Kelli A Corning, Mitchell R Levy, William E Greenberg
INTRODUCTION: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents. METHODS: The authors distributed an anonymous online survey regarding definitions of ownership to faculty and residents at the psychiatry and internal medicine residency programs at the University of Washington and the Harvard Longwood psychiatry residency and conducted a qualitative analysis of free-text responses to identify emergent themes...
December 5, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29209658/surgical-pathology-resident-rotation-restructuring-at-a-tertiary-care-academic-center
#16
Chelsea R Mehr, Amrom E Obstfeld, Amanda C Barrett, Kathleen T Montone, Lauren E Schwartz
Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems...
January 2017: Academic Pathology
https://www.readbyqxmd.com/read/29203407/optimising-workflow-processes-in-an-advanced-medication-dispensary
#17
Amanda Y Leong, Mary Pederson
The workload measurement of an inpatient hospital dispensary is critical to improve efficiency in the face of limited budgets. This single-centre pilot study used work sampling to observe and identify areas to improve efficiency of dispensing prescribed medications at one tertiary level acute care teaching hospital. Workload sampling was conducted at a 1096-bed hospital in Calgary, Alberta, Canada. The dispensary services the entire hospital, 24 h per day, seven days per week. Pharmacists are solely involved in clinical screening...
November 27, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29190403/family-medicine-didactics-revisited
#18
Dennis J Butler, Joseph Brocato, Mark Yeazel
BACKGROUND AND OBJECTIVES: All family medicine programs are required to provide specialty-specific didactic conferences for residents. Since a baseline study of family medicine didactic formats was published in 2000, training requirements have changed, core content has evolved, and new teaching strategies have been recommended. The present study examines the characteristics of current family medicine didactics, compares current and past conference format data, and identifies factors affecting content selection...
November 2017: Family Medicine
https://www.readbyqxmd.com/read/29190075/supramolecularly-caged-green-emitting-ionic-ir-iii-based-complex-with-fluorinated-c-n-ligands-and-its-application-in-light-emitting-electrochemical-cells
#19
Jude Namanga, Niels Gerlitzki, Volodymyr Smetana, Anja-Verena Mudring
Ionic Ir(III) complexes are the most promising emitters in light emitting electrochemical cells (LECs), especially in the high energy emission range for which it is difficult to find emitters with sufficient efficiencies and lifetimes. To overcome this challenge, the concept of intramolecular π-π-stacking of an ancillary ligand (6-phenyl-2,2'-bipyridine, pbpy) is intro-duced in the design of a new green emitting iridium ionic transition metal complex with a fluoro-substituted cyclometal-lated ligand, 2-(4-fluorophenyl)pyridinato (4Fppy)...
November 30, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29182074/enclosure-design-for-flock-level-chronic-exposure-of-birds-to-air-contaminant-mixtures
#20
Michelle A North, David W Kinniburgh, Judit E G Smits
The objective of this study was to design an enclosure suitable for studying the ecotoxicological effects of vehicle emissions on groups of wild birds without compromising welfare. Two, adjacent enclosures sheltered from sunlight, wind and rain, were bird-proofed and wrapped with thick polyethylene sheeting. Emissions were directed into the treatment enclosure from the exhaust of a light-duty gasoline truck, using flexible, heat-proof pipe, with joins sealed to prevent leakage. During active exposure, the engine was idled for five hours per day, six days per week for four weeks...
November 28, 2017: Toxicology Mechanisms and Methods
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