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Institute of Medicine

Rebecca L Emery, Maria Tina Benno, Rachel H Salk, Rachel P Kolko, Michele D Levine
Limited research has examined the factors related to knowledge of gestational weight gain (GWG) recommendations and the receipt of advice from healthcare providers regarding GWG recommendations among women with pre-pregnancy overweight/obesity. Women with pre-pregnancy overweight/obesity (N = 191) reported the amount of gestational weight they believed they should gain and that healthcare providers advised them to gain. Only 24% (n = 46) of women had a correct knowledge of GWG recommendations. Women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged...
March 22, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Anna U Morgan, Krisda H Chaiyachati, Gary E Weissman, Joshua M Liao
Gender-based discrimination and bias are widespread in professional settings, including academic medicine. Overt manifestations such as sexual harassment have long been identified but attention is only more recently turning towards subtler forms of bias, including inequity in promotion and compensation. Barriers to progress vary across institutions and include lack of awareness, inadequate training, poor informational transparency, and challenging power dynamics. We propose five solutions that the academic medical community can adopt to not only name, but also address, gender-based bias as the proverbial elephant in the room: definitively identify the systemic nature of the problem, prompt those with influence and power to advance a culture of equity, broadly incorporate evidence-based explicit anti-sexist training, increase transparency of information related to professional development and compensation, and use robust research methods to study the drivers and potential solutions of gender inequity within academic medicine...
March 21, 2018: Journal of General Internal Medicine
Gaurav Nepal, Eans T Tuladhar, Keshav Acharya, Aseem Bhattarai, Vijay K Sharma, Mithileshwor Raut, Binod K Yadav
Introduction Cardiovascular diseases are one of the main causes of morbidity and mortality worldwide, atherosclerosis being the principal underlying cause of cardiovascular diseases. Early detection of dyslipidemia and long-term prevention of atherosclerosis by controlling risk factors should begin in young age. The purpose of this study was to assess dyslipidemia and associated cardiovascular risk factors among university students of Nepal. Methods A sample of 280 students aged 17-24 years, were selected randomly from Institute of Medicine, Tribhuvan University...
January 20, 2018: Curēus
Annika L Windon, Arturo Loaiza-Bonilla, Christopher E Jensen, Michael Randall, Jennifer J D Morrissette, Stuti G Shroff
Background: The KRAS oncogene is a driver mutation and is present in greater than 90% of pancreatic ductal adenocarcinomas (PDAC). A subset of these tumors, however, do not harbor mutations in KRAS (wild type KRAS ). Studies have shown that patients with mutated KRAS have a poorer survival on first-line gemcitabine-based chemotherapy compared to wild type KRAS . In this study, we examined a cohort of patients with PDAC at our institution who were either wild type or mutant for the KRAS gene and assessed for differences in survival and response to different chemotherapeutic regimens...
February 2018: Journal of Gastrointestinal Oncology
Junko Hirooka-Nakama, Kimiko Enomoto, Kentaro Sakamaki, Kentaro Kurasawa, Etsuko Miyagi, Shigeru Aoki
We aimed to determine the optimal gestational weight gain (GWG) in Japanese women with a Body Mass Index (BMI) ≥25 kg/m2 . The present retrospective study investigated singleton pregnancies in 6,781 Japanese women registered in the Japan Society of Obstetrics and Gynecology system in 2013. We divided overweight and obese women into four GWG categories based on the Institute of Medicine (IOM) recommended: weight loss, small weight gain, within IOM criteria, and above IOM criteria. The adjusted odds ratios and predicted probabilities of maternal and neonatal outcomes of interest with weight change were calculated...
March 20, 2018: Endocrine Journal
Tali Capua, Zohar Bar Kama, Ayelet Rimon
BACKGROUND: The emergency department (ED) setting is an environment where children may experience intense physical pain and emotional stress. This study sought to determine the availability of pain and anxiety management practices in all Israeli emergency departments which accept children, specifically looking for differences between accredited pediatric emergency medicine departments and others. METHODS: A cross-sectional survey of all Israeli emergency departments that accept children was performed...
March 21, 2018: Israel Journal of Health Policy Research
Flora Tzelepis, Tara Clinton-McHarg, Christine L Paul, Robert W Sanson-Fisher, Douglas Joshua, Mariko L Carey
The Institute of Medicine has recommended that improvements are needed in patient-centered care. This study examined hematological cancer patients' perceptions of which aspects of cancer care were being delivered well and areas that required improvement, and whether patient characteristics, or the treatment center they attended, were associated with quality of patient-centered care. Participants were recruited via three Australian hematological cancer treatment centers and completed a paper-and-pen survey assessing sociodemographic, disease, and psychological and treatment characteristics at recruitment...
March 19, 2018: International Journal of Environmental Research and Public Health
Talita Sousa Queiroz, Tania Cristina Morais Santa Barbara Rehem, Marina Morato Stival, Silvana Schwerz Funghetto, Luciano Ramos de Lima, Breno Guilherme Cardoso, Walterlânia Silva Santos
OBJECTIVE: To understand the care of elderly men with their own health. METHOD: A qualitative study with the participation of ten elderly men, through responses to the semi-structured interview guided by the "Tell me about your experiences of care with your health", carried out in a basic health unit, during the period of October-December 2014. The speeches, after being transcribed were submitted to content analysis. RESULTS: The ten interviewees were retired and had an average age of 67...
2018: Revista Brasileira de Enfermagem
Rebecca Simon, Sharon W Lahiri
OBJECTIVE: To identify provider recommendations and barriers in obesity management in a multicenter academic health system with extensive weight-loss management resources. METHODS: A 26-question online survey was sent to attending physicians, trainees, and advanced practice providers in primary care specialties (internal medicine, family medicine, women's health) and endocrinology. RESULTS: The survey response rate was 26% (111/430). Of respondents, 50% were internal medicine, 24% family medicine, 16% women's health, and 9% endocrinology...
March 21, 2018: Endocrine Practice
Ludwig Apers, Eric Florence, Tania Crucitti, Nabila Anwar
Objective of this study was to describe the patient characteristics and clinical presentation of laboratory confirmed lymphogranuloma venereum (LGV) cases, diagnosed at the Institute of Tropical Medicine (ITM), Antwerp, Belgium. Demographic and biomedical characteristics of all patients with chlamydia-positive sample results were retrieved for the years 2013 and 2014. Samples were obtained from both symptomatic and asymptomatic patients who consulted at the HIV/STI clinic. Fifty four patients with laboratory confirmed LGV were detected among 3885 nucleic acid amplification tests (NAATs) performed for the detection of chlamydia during the two years under review...
July 2017: Acta Gastro-enterologica Belgica
Jamal Seidi, Fatemeh Alhani, Farasat Ardalan
Background: Clinical judgment of nurses to conduct medication orders is based on patient assessment, medication knowledge, observation, and interpretation of the data collected. This process is influenced by many factors. Objective: This study aims to explore nurses' experience about facilitating factors in medication administration based on clinical judgment of nurses. Methods: This qualitative study was part of an approved project research of the Iranian National Institute of Health Research, which was conducted in Kurdistan University of Medical Sciences in 2015...
December 2017: Electronic Physician
Christopher J Smith, Russell J Buzalko, Nathan Anderson, Joel Michalski, Jordan Warchol, Stephen Ducey, Chad E Branecki
Introduction: Miscommunication during inter-unit handoffs between emergency and internal medicine physicians may jeopardize patient safety. Our goal was to evaluate the impact of a structured communication strategy on the quality of admission handoffs. Methods: We conducted a mixed-methods, pre-test/post-test study at a 560-bed academic health center with 60,000 emergency department (ED) patient visits per year. Admission-handoff best practices were integrated into a modified SBAR format, resulting in the Situation, Background, Assessment, Responsibilities & Risk, Discussion & Disposition, Read-back & Record (SBAR-DR) model...
March 2018: Western Journal of Emergency Medicine
Matthew W Zackoff, Camille Graham, Denise Warrick, Kathleen Pulda, Craig Gosdin, Blair Simpson, Jessica Marischen, Paul Bunch, Michael Vossmeyer, Grant M Mussman
OBJECTIVES: During hospital admission, communication between primary care physicians (PCPs) and hospital medicine (HM) physicians provides an opportunity for collaboration. Two-way communication facilitates collaboration by allowing the receiver to ask and respond to questions. At our institution, most HM-to-PCP communication occurred by telephone call after discharge. Our specific aim was to increase the percentage of patients for whom a telephone conversation occurred between HM and PCPs during hospital admission from 40% to >80%...
March 20, 2018: Hospital Pediatrics
Barend L Penzhorn
Finding a healthy balance between classical parasitology and clinical veterinary medicine remains a challenge. Veterinary parasitology, of vital interest in sub-Saharan Africa, has always featured prominently at the Faculty of Veterinary Science, University of Pretoria (founded in 1920). The faculty was initially an integral part of the Onderstepoort Veterinary Institute (OVI), and parasitology was taught by specialist researchers from OVI - a cult of total coverage prevailed. Presenting three separate courses - ectoparasitology, helminthology and protozoology - continued for many decades...
March 15, 2018: Veterinary Parasitology
Venkat Boddapati, Ridhi Sachdev, Michael C Fu, Christopher L Camp, Robert G Marx, Joshua S Dines
BACKGROUND: Orthopaedic surgeons receive a disproportionately small share of funding from the National Institutes of Health, but they receive the largest amount of funding from industry sources. The purpose of this study was to examine the association between payments from industry partners and research productivity among orthopaedic research authors, as well as to identify predictors of high research productivity. METHODS: United States-based physicians who published an article in 2016 in The Journal of Bone & Joint Surgery or The American Journal of Sports Medicine were included in this study...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
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
Abhishekl Agarwal, Sakshi Batra, Rajendra Prasad, Anand Verma, Abdul Q Jilani, Surya Kant
Chronic obstructive pulmonary disease (COPD) is one of the few respiratory diseases which is associated with a number of comorbidities. Psychiatric disease like depression is a very important comorbidity of COPD because it decreases the feeling of wellbeing in the patient and also interferes with the compliance with medication thereby increasing the risk of hospitalization in the COPD patient. A cross-sectional study was done for two years in the department of pulmonary medicine at Era's Lucknow medical college and hospital, Lucknow...
March 19, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Todd M Olszewski
This article examines the history and effect of the Consensus Development Program (CDP) at the National Institutes of Health (NIH). Introduced at a time when the relationship between the U.S. public and the medical profession was at a nadir, the CDP frequently placed the NIH in the middle of broader debates in medical practice and health policy during the last quarter of the 20th century. Drawing on published and archival sources, this paper sheds light on the challenges associated with collecting, assessing, and communicating evidence to medical professionals and convincing them to act on it in the name of improved health care...
March 20, 2018: Annals of Internal Medicine
Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Chitra Andrew, Teena Koshy, Shivani Gopal, Solomon Franklin Durairaj Paul
This is a retrospective analysis of the patient demographics and cytogenetic results of patients who underwent prenatal invasive testing for genetic analysis at the Foetal Medicine Division of the Department of Obstetrics and Gynecology, Sri Ramachandra Medical College and Research Institute. The main objective of this study was to characterise the changing trends in indications of pregnant women for foetal karyotyping in a 7-year period. A total of 257 procedures were performed in this period, and there was a significant change in the trend of indications for invasive prenatal diagnosis from an advanced maternal age in 2009 to a positive screen test by 2014...
March 19, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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