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https://www.readbyqxmd.com/read/27932029/implementing-a-resident-acute-care-surgery-service-improving-resident-education-and-patient-care
#1
Olga Kantor, Andrew B Schneider, Marko Rojnica, Andrew J Benjamin, Nancy Schindler, Mitchell C Posner, Jeffrey B Matthews, Kevin K Roggin
BACKGROUND: To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. METHODS: We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27930394/the-changing-face-of-epidemiology-gender-disparities-in-citations
#2
Enrique F Schisterman, Chandra W Swanson, Ya-Ling Lu, Sunni L Mumford
BACKGROUND: Female biomedical scientists tend to publish fewer articles as last author than their male colleagues and accrue fewer citations per publication. We seek to understand whether epidemiology follows this pattern. METHODS: We gathered aggregate information on the current gender distribution of epidemiology departments (n=29 of 71 surveyed), societies (n=4 of 8), and journal editorial boards (n=6 of 6) using two online surveys and publicly available online information...
December 1, 2016: Epidemiology
https://www.readbyqxmd.com/read/27928743/age-effects-in-mortality-risk-valuation
#3
Raul Brey, Jose Luis Pinto-Prades
We provide more evidence on the functional relationship between willingness-to-pay for risk reductions and age (the senior discount). We overcome many of the limitations of previous literature that has dealt with this issue, namely, the influence of the assumptions used in statistical models on the final results. Given our large sample size (n = 6024) we can use models that are very demanding on data. We use parametric (linear, quadratic, dummies), semi-nonparametric, and non-parametric models. We also compare the marginal and the total approach and show that they provide similar results...
December 7, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27928671/effective-stepwise-training-and-procedure-standardization-for-young-surgeons-to-perform-laparoscopic-left-hepatectomy
#4
Shinichiro Yamada, Mitsuo Shimada, Satoru Imura, Yuji Morine, Tetsuya Ikemoto, Yu Saito, Chie Takasu, Masato Yoshikawa, Hiroki Teraoku, Toshiaki Yoshimoto, Atsushi Takata
BACKGROUND: Laparoscopic hepatectomy remains one of the most difficult procedures for young surgeons to perform. We recently developed a new training method and standardization procedure for teaching young surgeons to perform laparoscopic left hepatectomy (Lap-LHx). The aim of this study was to assess the effectiveness of our method. METHODS: In 2004, we standardized a laparoscopic procedure for Lap-LHx, using a laparoscopy-assisted method as a stepping stone. The laparoscopic training method comprised the following three steps: (1) training in fundamental procedures using a dry box and checking by mentors; (2) detailed preoperative simulation using Vincent three-dimensional software for each patient; and (3) self-assessment including understanding of relevant anatomy and completion grade for each procedure using a check sheet and feedback by both mentors and a professor...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27927937/brain-activation-in-high-functioning-older-adults-and-falls-prospective-cohort-study
#5
Joe Verghese, Cuiling Wang, Emmeline Ayers, Meltem Izzetoglu, Roee Holtzer
OBJECTIVE: To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. METHOD: We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet)...
December 7, 2016: Neurology
https://www.readbyqxmd.com/read/27927729/offsetting-the-effects-of-medical-expenses-on-older-adults-household-food-budgets-an-analysis-of-the-standard-medical-expense-deduction
#6
Grace Bagwell Adams, Jung Sun Lee, Vibha Bhargava, David A Super
The Supplemental Nutrition Assistance Program (SNAP) provides critical nutrition assistance to over 40 million Americans each month. Low-income older adults (60 and older) and disabled participants experience additional budgetary constraints because of high out-of-pocket medical expenses. In recent years, some states have adopted a "Standard Medical Expense Deduction" (SMED) for senior and disabled beneficiaries, making it easier to report medical expenses in the SNAP application process. We conduct a descriptive national analysis that shows increases in benefit levels and reporting of medical expenses for states that have implemented SMED...
December 7, 2016: Gerontologist
https://www.readbyqxmd.com/read/27925859/home-and-community-based-service-and-other-senior-service-use-prevalence-and-characteristics-in-a-national-sample
#7
Amanda Sonnega, Kristen Robinson, Helen Levy
We report on the use of home- and community-based services and other senior services and factors affecting utilization of both among Americans over age 60 in the Health and Retirement Study. Those using home- and community-based services were more likely than to be older, single, Black, lower income, receiving Medicaid, and in worse health. Past use of less traditional senior services, such as exercise classes and help with tax preparation, were found to are associated with current use of home- and community-based services...
December 7, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#8
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925146/assessment-of-diagnostics-tools-for-sarcopenia-severity-using-the-item-response-theory-irt
#9
M Steffl, M Musalek, V Kramperova, M Petr, E Kohlikova, I Holmerova, L Volicer
OBJECTIVE: To use the item response theory (IRT) methods to examine the degree to which the four selected tools reflect sarcopenia and to arrange them according to their ability to estimate sarcopenia severity. DESIGN: A cross-sectional study aimed at verifying the possibilities of using diagnostic tools for sarcopenia. SETTING AND PARTICIPANTS: The study included residents living in an assisted living unit at the Senior Centre in Blansko (South Moravia, Czech Republic) (n=77)...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27923596/revision-hip-arthroplasty-using-a-modular-cementless-femoral-stem-intermediate-term-follow-up
#10
Sureshan Sivananthan, Chin-Tat Lim, Rapeepat Narkbunnam, Alex Sox-Harris, James I Huddleston, Stuart B Goodman
BACKGROUND: Modular femoral stem provides flexibility in femoral reconstruction, ensuring improved "fit and fill". However, there are risks of junction failure and corrosion, as well as cost concerns in the use of modular femoral stems. METHODS: We reviewed prospectively-gathered clinical and radiographic data on revision total hip arthroplasties (THAs) performed from 2001-2007 using modular, cementless femoral component performed by the 2 senior authors. Patients with a minimum follow-up of 7 years were included in this study...
November 2, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27920415/endoscopic-monopolar-cauterization-of-the-sphenopalatine-artery-a-single-surgeons-experience
#11
Haitham Odat, Mohannad Al-Qudah
BACKGROUND: Epistaxis is one of the most common otolaryngology emergency conditions, and is usually treated conservatively by different types of nasal packs. A limited number of patients continue to bleed even with tightly fitted anterior and posterior packs in the nose. Such intractable epistaxis is managed by surgery or embolization. OBJECTIVES: We reviewed the use and outcomes of endoscopic suction monopolar cauterization of the sphenopalatine artery. DESIGN: Retrospective study...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27920031/what-are-we-doing-a-survey-of-united-states-nephrology-fellowship-program-directors
#12
Scott E Liebman, Catherine A Moore, Rebeca D Monk, Mahrukh S Rizvi
Interest in nephrology has been declining in recent years. Long work hours and a poor work/life balance may be partially responsible, and may also affect a fellowship's educational mission. We surveyed nephrology program directors using a web-based survey in order to define current clinical and educational practice patterns and identify areas for improvement. Our survey explored fellowship program demographics, fellows' workload, call structure, and education. Program directors were asked to estimate the average and maximum number of patients on each of their inpatient services, the number of patients seen by fellows in clinic, and to provide details regarding their overnight and weekend call...
December 5, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27914903/cognitive-behavioural-therapy-and-short-term-psychoanalytical-psychotherapy-versus-a-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depressive-disorder-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-superiority-trial
#13
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. METHODS: We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England...
November 30, 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27912008/heterogeneity-in-ecological-and-evolutionary-meta-analyses-its-magnitude-and-implications
#14
Alistair M Senior, Catherine E Grueber, Tsukushi Kamiya, Malgorzata Lagisz, Katie O'Dwyer, Eduardo S A Santos, Shinichi Nakagawa
Meta-analysis is the gold standard for synthesis in ecology and evolution. Together with estimating overall effect magnitudes, meta-analyses estimate differences between effect sizes via heterogeneity statistics. It is widely hypothesized that heterogeneity will be present in ecological/evolutionary meta-analyses due to the system-specific nature of biological phenomena. Despite driving recommended best practices, the generality of heterogeneity in ecological data has never been systematically reviewed. We reviewed 700 studies, finding 325 that used formal meta-analysis, of which total heterogeneity was reported in fewer than 40%...
December 2016: Ecology
https://www.readbyqxmd.com/read/27910796/reinforcement-of-emergency-department-reduces-acute-admissions-to-medical-department
#15
Mansoor Ahmed Dawood, Gideon Ertner, Jacob Hansen-Schwartz
INTRODUCTION: The medical decision capacity of emergency departments (ED) may rest within the department itself or depend on external consultation. The stepwise development of the ED at Zealand University Hospital, Køge, was used to analyse the influence of medical organisation in the ED on the hospital admission pattern. METHODS: Data were recorded for the month of September of 2009, 2012 and 2014. These periods corresponded to the establishment of the department in 2009 and the 2012-period before organisational change was initiated in 2013, with a substantial increase in the number of senior physicians directly in charge of clinical decisions and the establishment of a limited bedding capacity...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27909119/impact-of-a-learning-curve-on-the-survivorship-of-4802-cementless-total-hip-arthroplasties
#16
P Magill, J Blaney, J C Hill, M P Bonnin, D E Beverland
AIMS: Our aim was to report survivorship data and lessons learned with the Corail/Pinnacle cementless total hip arthroplasty (THA) system. PATIENTS AND METHODS: Between August 2005 and March 2015, a total of 4802 primary cementless Corail/Pinnacle THAs were performed in 4309 patients. In March 2016, we reviewed these hips from a prospectively maintained database. RESULTS: A total of 80 hips (1.67%) have been revised which is equivalent to a cumulative risk of revision of 2...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27904932/-the-reverse-shoulder-arthroplasty-delta-xtend-mid-term-results
#17
S Gruber, C Schoch, M Geyer
BACKGROUND: Reverse shoulder arthroplasty (RSA) has become a frequently used and established treatment for patients with cuff tear arthropathy, increasingly also for patients with fracture sequelae (FS), failed rotator cuff reconstruction and omarthrosis with cuff insufficiency. Since 2007 new generation prostheses, for example Delta Xtend (Depuy, Warsaw, USA), have been used, but few mid-term results have been published. OBJECTIVES: The aim of this study is to report on the outcome after RSA after a mean follow-up of 68 months (range 63-75), to verify the already published, encouraging early results and to learn about the function and pain situation after RSA in the mid-term period...
November 30, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27900271/prosthetic-design-of-reverse-shoulder-arthroplasty-contributes-to-scapular-notching-and-instability
#18
Gazi Huri, Filippo Familiari, Nima Salari, Steve A Petersen, Mahmut Nedim Doral, Edward G McFarland
AIM: To evaluate whether implant design, glenoid positioning, and other factors influenced instability and scapular notching in reverse total shoulder arthroplasty. METHODS: We retrospectively reviewed records of patients who had undergone reverse total shoulder arthroplasty by the senior author from July 2004 through October 2011 and who had at least 24 mo of follow-up. The 58 patients who met the criteria had 65 arthroplasties: 18 with a Grammont-type prosthesis (Grammont group) and 47 with a lateral-based prosthesis (lateral-design group)...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27895908/diathermy-awareness-among-surgeons-an-analysis-in-ireland
#19
P M McQuail, B S McCartney, J F Baker, P Kenny
INTRODUCTION: Diathermy is an integral part of many modern surgical procedures. While diathermy is generally accepted as 'safe', electrosurgery-induced injuries are among the more common causes for malpractice litigation. The purpose of this study was to evaluate the awareness among surgeons of the principles, risks, precautions and appropriate use of diathermy. METHODS: All surgeons employed from Senior House Officer (SHO) to Consultant grade in two teaching hospitals were surveyed...
December 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27894609/what-is-the-problem-with-medically-unexplained-symptoms-for-gps-a-meta-synthesis-of-qualitative-studies
#20
REVIEW
May-Lill Johansen, Mette Bech Risor
OBJECTIVE: To gain a deeper understanding of challenges faced by GPs when managing patients with MUS. METHODS: We used meta-ethnography to synthesize qualitative studies on GPs' perception and management of MUS. RESULTS: The problem with MUS for GPs is the epistemological incongruence between dominant disease models and the reality of meeting patients suffering from persistent illness. GPs have used flexible approaches to manage the situation, yet patients and doctors have had parallel negative experiences of being stuck, untrustworthy and helpless...
November 21, 2016: Patient Education and Counseling
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