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https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#1
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27924368/a-quantitative-readability-analysis-of-patient-education-resources-from-gastroenterology-society-websites
#2
David R Hansberry, Sahil R Patel, Prateek Agarwal, Nitin Agarwal, Elizabeth S John, Ann M John, James C Reynolds
BACKGROUND AND AIMS: The lay public frequently access and rely on online information as a source of their medical knowledge. Many medical societies are unaware of national patient education material guidelines and subsequently fail to meet them. The goal of the present study was to evaluate the readability of patient education materials within the medical field of gastroenterology. METHODS: Two hundred fourteen articles pertaining to patient education materials were evaluated with ten well-established readability scales...
December 6, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27899520/is-adherence-to-the-american-college-of-chest-physicians-recommended-anticoagulation-treatment-duration-associated-with-different-outcomes-among-patients-with-venous-thromboembolism
#3
Alex C Spyropoulos, Ron Preblick, Winghan J Kwong, Melissa Lingohr-Smith, Jay Lin
Clinical and economic outcomes associated with venous thromboembolism (VTE) patient adherence to the American College of Chest Physicians (ACCP) anticoagulant (AC) treatment guidelines are incompletely understood. Patients with ≥1 inpatient or ≥2 separate outpatient claims for deep vein thrombosis and/or pulmonary embolism, based on International Classification of Diseases, Ninth Revision, Clinical Modification codes, were identified from the IMS PharMetrics Plus database. Patients had continuous insurance coverage for 12 months before (baseline) and after (follow-up) the index event (first VTE claim) but no baseline VTE claims...
November 28, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27898136/pharmacological-approaches-for-the-management-of-persistent-pain-in-older-adults-what-nurses-need-to-know
#4
Fabio Guerriero, Ruth Bolier, Janet H Van Cleave, M Cary Reid
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27896846/international-study-of-medical-school-learning-environments-and-their-relationship-with-student-well-being-and-empathy
#5
Sean Tackett, Scott Wright, Robert Lubin, Jianing Li, Hui Pan
OBJECTIVE: To assess whether favourable perceptions of the learning environment (LE) were associated with better quality of life, less burnout and more empathy across three undergraduate medical education programmes in Israel, Malaysia and China. METHODS: Cross-sectional surveys were administered at the end of the 2013-2014 academic year at three medical schools: Technion American Medical Students Program (TAMS) in Israel, Perdana University-Royal College of Surgeons in Ireland School of Medicine (PURCSI) in Malaysia and Peking Union Medical College (PUMC) in China...
November 29, 2016: Medical Education
https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#6
Bryce A Basques, Ryan P McLynn, Michael P Fice, Andre M Samuel, Adam M Lukasiewicz, Daniel D Bohl, Junyoung Ahn, Kern Singh, Jonathan N Grauer
BACKGROUND: National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27893030/development-and-initial-validation-of-the-risk-analysis-index-for-measuring-frailty-in-surgical-populations
#7
Daniel E Hall, Shipra Arya, Kendra K Schmid, Casey Blaser, Mark A Carlson, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason Johanning
Importance: Growing consensus suggests that frailty-associated risks should inform shared surgical decision making. However, it is not clear how best to screen for frailty in preoperative surgical populations. Objective: To develop and validate the Risk Analysis Index (RAI), a 14-item instrument used to measure surgical frailty. It can be calculated prospectively (RAI-C), using a clinical questionnaire, or retrospectively (RAI-A), using variables from the surgical quality improvement databases (Veterans Affairs or American College of Surgeons National Surgical Quality Improvement Projects)...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27884391/basic-airway-skills-acquisition-using-the-american-college-of-surgeons-association-for-surgical-education-medical-student-simulation-based-surgical-skills-curriculum-initial-results
#8
Sydne Muratore, Michael Kim, Jaisa Olasky, Andre Campbell, Robert Acton
BACKGROUND: The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. METHODS: This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario)...
November 4, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#9
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27875347/severe-low-gradient-aortic-stenosis-with-preserved-ventricular-function-should-it-be-treated
#10
Giuseppe Di Pasquale, Gloria Vassilikì Coutsoumbas, Silvia Zagnoni
Exists a group of patients with small AVA (<0,6 cm/m), and normal LVEF (≥50%) who display a low transvalvular flow (LF) [index stroke volume (SVi)<35 ml/m2] and/or low transvalvular gradient (LG). This condition is called severe paradoxical aortic stenosis (SAO) LFLG. In many studies this condition was associated to increased mortality both with medical therapy and with surgical intervention. Crucial is define correctly the diagnostical criteria of this condition. Indeed there are several specific anatomical and functional characteristics useful in differentiating paradoxical severe aortic stenosis from the other forms of aortic stenosis...
November 19, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27864237/effect-of-selected-clinical-trial-publication-on-adjunctive-nonstatin-medication-prescribing-in-the-veterans-health-administration-system
#11
Krystal S Titus-Rains, Matthew A Cantrell, Jason A Egge, Bruce Alexander, Robert F Shaw, Tami R Argo
PURPOSE: The question of whether publication of selected clinical trials is temporally followed by changes in prescribing of adjunctive lipid-lowering medications was evaluated. METHODS: In this retrospective preanalysis and postanalysis, Veterans Health Administration (VHA) patients 18 years or older who received a new or renewed order for any lipid-lowering medication between April 2, 2004, and September 2, 2014, were included. This period was chosen based on the publication dates of three trials investigating the efficacy of nonstatin medications: Simvastatin with or without Ezetimibe in Familial Hypercholesterolemia (ENHANCE, April 3, 2008), Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus (ACCORD Lipid, March 14, 2010), and Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy (AIM-HIGH, December 15, 2011)...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27858534/lumbar-decompression-in-the-elderly-increased-age-as-a-risk-factor-for-complications-and-nonhome-discharge
#12
Meghan E Murphy, Hannah Gilder, Patrick R Maloney, Brandon A McCutcheon, Lorenzo Rinaldo, Daniel Shepherd, Panagiotis Kerezoudis, Daniel S Ubl, Cynthia S Crowson, William E Krauss, Elizabeth B Habermann, Mohamad Bydon
OBJECTIVE With improving medical therapies for chronic conditions, elderly patients increasingly present as candidates for operative intervention for degenerative diseases of the spine. To date, there is a paucity of studies examining complications in lumbar decompression, without fusion, that include patients older than 80 years. Using a multicenter national database, the authors of this study evaluated lumbar decompression in the elderly, including octogenarians, to evaluate for associations between age and patient outcomes...
November 18, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27855953/increasing-cardiac-rehabilitation-participation-from-20-to-70-a-road-map-from-the-million-hearts-cardiac-rehabilitation-collaborative
#13
REVIEW
Philip A Ades, Steven J Keteyian, Janet S Wright, Larry F Hamm, Karen Lui, Kimberly Newlin, Donald S Shepard, Randal J Thomas
The primary aim of the Million Hearts initiative is to prevent 1 million cardiovascular events over 5 years. Concordant with the Million Hearts' focus on achieving more than 70% performance in the "ABCS" of aspirin for those at risk, blood pressure control, cholesterol management, and smoking cessation, we outline the cardiovascular events that would be prevented and a road map to achieve more than 70% participation in cardiac rehabilitation (CR)/secondary prevention programs by the year 2022. Cardiac rehabilitation is a class Ia recommendation of the American Heart Association and the American College of Cardiology after myocardial infarction or coronary revascularization, promotes the ABCS along with lifestyle counseling and exercise, and is associated with decreased total mortality, cardiac mortality, and rehospitalizations...
November 14, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27846735/perioperative-management-of-dual-anti-platelet-therapy
#14
Tyler D Webster, Prashant Vaishnava, Kim A Eagle
Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. While there is uncertainty about the optimal duration of dual antiplatelet therapy following percutaneous coronary intervention, the new 2016 American College of Cardiology/American Heart Association Guidelines suggest that for patients with stable ischemic heart disease at least six months of such therapy following a drug eluting stent and one month following a bare metal stent should be implemented...
December 4, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27846298/damage-in-the-multiethnic-malaysian-systemic-lupus-erythematosus-sle-cohort-comparison-with-other-cohorts-worldwide
#15
Syahrul Sazliyana Shaharir, Heselynn Hussein, Sakthiswary Rajalingham, Mohd Shahrir Mohamed Said, Abdul Halim Abdul Gafor, Rozita Mohd, Ruslinda Mustafar
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease and despite the improvement in the survival in the past few decades, the morbidity due to disease damage remains significant. The objectives of this study were to investigate the disease damagepattern and determine the associated factors of damage in the multi-ethnic Malaysian SLE patients. We consecutively 424SLE patients who attended a consistent follow-up at the National University of Malaysia Medical Centre and Putrajaya Hospital were recruited...
2016: PloS One
https://www.readbyqxmd.com/read/27843372/wissler-fanconi-syndrome-and-related-diagnoses-a-case-report
#16
Mustafa Q Albustani, Robert F Howard
INTRODUCTION: Wissler-Fanconi syndrome is a rare rheumatic syndrome that was first described during the 1940s in Europe. Since then, many papers have been written that cover all aspects of this syndrome, most of which are in French and German language, with only a very few in English (none of them recent). We report here a case that fulfils the criteria for Wissler-Fanconi syndrome. Under the more general descriptive umbrella of Wissler-Fanconi syndrome, our patient also fulfils the Modified Jones criteria, and the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis, and was interpreted by other internists and another rheumatologist as fulfilling the Yamaguchi criteria for adult onset Still's disease...
2016: Open Access Rheumatol
https://www.readbyqxmd.com/read/27818848/an-examination-of-cultural-competence-training-in-us-medical-education-guided-by-the-tool-for-assessing-cultural-competence-training
#17
Valarie Blue Bird Jernigan, Jordan B Hearod, Kim Tran, Keith C Norris, Dedra Buchwald
In the United States, medical students must demonstrate a standard level of "cultural competence," upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements...
2016: Journal of Health Disparities Research and Practice
https://www.readbyqxmd.com/read/27818431/training-medical-students-for-rural-underserved-areas-a-rural-medical-education-program-in-california
#18
W Suzanne Eidson-Ton, Julie Rainwater, Donald Hilty, Stuart Henderson, Christine Hancock, Cathryn L Nation, Thomas Nesbitt
The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27816542/pharmacogenomics-competencies-in-pharmacy-practice-a-blueprint-for-change
#19
Mary W Roederer, Grace M Kuo, David F Kisor, Reginald F Frye, James M Hoffman, Jean Jenkins, Kristin Wiisanen Weitzel
The emerging use of genomic data to inform medication therapy populates the medical literature and provides evidence for guidelines in the prescribing information for many medications. Despite the availability of pharmacogenomic studies, few pharmacists feel competent to use these new data in patient care. The first pharmacogenomics competency statement for pharmacists was published in 2002. In 2011, the Pharmacogenomics Special Interest Group of the American Association of Colleges of Pharmacy led a process to update this competency statement with the use of a consensus-based method that incorporated input from multiple key professional pharmacy organizations to reflect growth in genomic science as well as the need for pharmacist application of genomic data...
November 2, 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27815803/advancements-in-undergraduate-medical-education-meeting-the-challenges-of-an-evolving-world-of-education-healthcare-and-technology
#20
REVIEW
P G Shelton, Irma Corral, Brandon Kyle
Restructuring of undergraduate medical education (UGME) has occurred from time to time over the past century. Many influences, including the persuasive report of Abraham Flexner in 1910, acted to reorganize medical education in the early twentieth century [1, 2]. In his report, Flexner called on American medical schools to enact higher graduation standards and to stringently adhere to the protocols of mainstream science in their teaching. Prior to this report, UGME had changed little over the previous century but over the last several decades, reform within medical education has become routine...
November 5, 2016: Psychiatric Quarterly
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