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Maritza C Alencar, Eileen Butler, Jessica MacIntyre, Evelyn P Wempe
Formal training is an important mechanism to assist the new generation of nurse practitioners (NPs) entering the complex field of oncology. The growing number of patients with cancer and the expansion of treatment options demand structured oncology training to support the transition of novice advanced practice nurses to the field. Oncology NP fellowships are a potential solution for those seeking training centered on the management of patients with cancer. This article discusses the process of implementing an NP fellowship program at an academic cancer center, including benefits and barriers...
April 1, 2018: Clinical Journal of Oncology Nursing
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Beth Herold, Karen St Claire, Scott Snider, Aditee Narayan
Child maltreatment is a leading cause of childhood morbidity in the United States, often leading to lifelong adverse health consequences. Currently, there is a nationwide shortage of child abuse pediatricians (CAPs), resulting in many unfilled child abuse positions throughout the United States. In addition, the number of future CAPs currently in fellowship training will meet neither the current need for CAPs nor provide replacements for the senior CAPs who will be retiring in the next 5 to 10 years. Although it is recognized that pediatric nurse practitioners (PNPs) play an important role in the care of maltreated children, there are few available data on the impact of the PNP as an integral member of the child abuse team...
March 12, 2018: Journal of Pediatric Health Care
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
R van Eekelen, R I Tjon-Kon-Fat, P M M Bossuyt, N van Geloven, M J C Eijkemans, A J Bensdorp, F van der Veen, B W Mol, M van Wely
STUDY QUESTION: What is the natural conception rate over the course of 12 months in couples with unexplained or mild male subfertility who are scheduled for fertility treatment and have a predicted unfavourable prognosis for natural conception? SUMMARY ANSWER: The natural conception rate over the course of 12 months in couples who were allocated to treatment was estimated to be 24.5% (95% CI: 20-29%). WHAT IS KNOWN ALREADY: After starting treatment, couples often perceive unsuccessful cycles as evidence of definitive failure even though they are still able to conceive naturally in between and after treatment...
March 12, 2018: Human Reproduction
Stephen Clark, Alysa Nash, Mark Shasti, Luke Brown, Julio J Jauregui, Katherine Mistretta, Eugene Koh, Kelley Banagan, Steven Ludwig, Daniel Gelb
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To assess 30-day and one-year mortality rates as well as the most common complications associated with posterior C1-2 fusion in an octogenarian cohort. SUMMARY OF BACKGROUND DATA: Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1-2 fusion results in improved survival as compared to other modes of treatment...
March 13, 2018: Spine
Sebastian T Tong, Camille J Hochheimer, Wendy B Barr, Matteo Leveroni-Calvi, Nicholas M Lefevre, Jordyn T Wallenborn, Lars E Peterson
BACKGROUND AND OBJECTIVES: Prior research found that 24% of graduating family medicine residents intend to provide obstetrical deliveries, but only 9% of family physicians 1 to 10 years into practice are doing so. Our study aims to describe the individual and residency program characteristics associated with intention to provide obstetrical deliveries and prenatal care. METHODS: Cross-sectional data on 2014-2016 graduating residents were obtained from the American Board of Family Medicine certification examination demographic questionnaire that asked about intended provision of specific clinical activities...
March 8, 2018: Family Medicine
Eric J Cotter, Charles P Hannon, Philip Locker, Annabelle Davey, Kevin C Wang, Nikhil N Verma, Brian J Cole
Background: Patient-reported outcome (PRO) surveys have become increasingly important in both improving patient care and assessing outcomes. Purpose/Hypothesis: The purpose of this study was to evaluate which variables are associated with compliance with completing PRO surveys in patients who have undergone anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that older patient age and longer time since ACLR would be associated with lower completion rates of PRO surveys preoperatively and at postoperative time points...
March 2018: Orthopaedic Journal of Sports Medicine
Bruce J Gantz
: A brief history of the evolution of Otology and Neurotology training in the United States is presented. The development of the Neurotology Fellowship accreditation process by the Accreditation Council on Graduate Education and the certification of neurotology fellows by the American Board of Otolaryngology is outlined.
April 2018: Otology & Neurotology
Karl A Poterack, Richard H Epstein, Franklin Dexter
All 36 physicians board-certified in both anesthesiology and clinical informatics as of January 1, 2016, were surveyed via e-mail, with 26 responding. Although most (25/26) generally expressed satisfaction with the clinical informatics boards, and view informatics expertise as important to anesthesiology, most (24/26) thought it unlikely or highly unlikely that substantial numbers of anesthesiology residents would pursue clinical informatics fellowships. Anesthesiologists wishing to qualify for the clinical informatics board examination under the practice pathway need to devote a substantive amount of worktime to informatics...
March 12, 2018: Anesthesia and Analgesia
Michael A Skinnider, David D W Twa, Jordan W Squair, Norman D Rosenblum, Christine D Lukac
CONTEXT: MD/PhD programmes provide structured paths for physician-scientist training. However, considerable proportions of graduates of these programmes do not pursue careers in research consistent with their training. OBJECTIVES: We sought to identify factors associated with sustained involvement in research after completion of all postgraduate training. METHODS: Anonymised data from a national survey of Canadian MD/PhD programme graduates who had completed all physician-scientist training (n = 70) were analysed...
March 13, 2018: Medical Education
Marianna Purgato, Alden L Gross, Theresa Betancourt, Paul Bolton, Chiara Bonetto, Chiara Gastaldon, James Gordon, Paul O'Callaghan, Davide Papola, Kirsi Peltonen, Raija-Leena Punamaki, Justin Richards, Julie K Staples, Johanna Unterhitzenberger, Mark van Ommeren, Joop de Jong, Mark J D Jordans, Wietse A Tol, Corrado Barbui
BACKGROUND: Results from studies evaluating the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in humanitarian settings in low-income and middle-income countries have been inconsistent, showing varying results by setting and subgroup (eg, age or gender). We aimed to assess the effectiveness of these interventions, and to explore which children are likely to benefit most. METHODS: We did a systematic review and meta-analysis of individual participant data (IPD) from 3143 children recruited to 11 randomised controlled trials of focused psychosocial support interventions versus waiting list...
April 2018: Lancet Global Health
Nishant Ganesh Kumar, Nicholas Hricz, Brian C Drolet
BACKGROUND: Carpal tunnel release (CTR) is the most common hand surgery operation performed in the United States. While serious complications are rare, they can be life-altering to patients. In some cases, patients will pursue malpractice claims against the surgeon. This study aimed to understand the patient, procedure, and surgeon factors involved in CTR malpractice litigation. METHODS: The Westlaw legal database was queried for all recorded CTR malpractice cases resulting in jury verdicts and settlements...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Ellen H de Moll
Dermatology is an exciting and rewarding specialty. Looking for jobs after training can be a daunting task. From deciding to pursue a fellowship or a job in private practice, the opportunities are extensive. I have collected advice from recent dermatology graduates to help jump-start the planning process.
January 2018: Cutis; Cutaneous Medicine for the Practitioner
Megan H M Kuba, Byron H Izuka
BACKGROUND: Previous studies have showed the efficacy of removable brace treatment for distal radius buckle fractures in children, whereas others have independently suggested that these injuries do not require additional radiographic imaging. However, no study has sought to collectively determine whether treating pediatric distal radius buckle fractures with a removable brace and no follow-up visit or imaging after the initial visit is a safe and satisfactory protocol. METHODS: In total, 42 consecutive patients with a distal forearm buckle fracture seen by a single fellowship trained pediatric orthopaedic surgeon were eligible to participate...
March 9, 2018: Journal of Pediatric Orthopedics
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
Kamal Gholipour, Jafar Sadegh Tabrizi, Mostafa Farahbakhsh, Shabnam Iezadi, Akbar Ghiasi, Hasan Jahanbin
OBJECTIVE: To evaluate the district health management fellowship training programme in the north-west of Iran. DATA SOURCES/STUDY SETTING: The programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province's health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015-2016...
March 9, 2018: BMJ Open
Imran A Siddiqui, Amit V Sastry, John B Martinie, Dionisios Vrochides, Erin H Baker, David A Iannitti
BACKGROUND: Sixteen hepatopancreatobiliary fellowship programs in North America are accredited by the Fellowship Council. This study aims to assess fellows' perceptions of their training program. METHODS: A multiple-choice questionnaire was sent to 35 fellows to assess how they perceived their training: academics, research, operative experiences, autonomy, mentorship, program quality and weaknesses. The survey was developed using the SurveyMonkey® tool. RESULTS: Twenty-four of 35 fellows completed the survey...
March 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
David E Elder, Mike Piepkorn, Raymond L Barnhill, Gary M Longton, Heidi D Nelson, Stevan R Knezevich, Margaret S Pepe, Patricia A Carney, Linda J Titus, Tracy Onega, Anna N A Tosteson, Martin A Weinstock, Joann G Elmore
BACKGROUND: Diagnostic interpretations of melanocytic skin lesions vary widely among pathologists, yet the underlying reasons remain unclear. OBJECTIVE: Identify pathologist characteristics associated with rates of accuracy and reproducibility. METHODS: Pathologists independently interpreted the same set of biopsies of melanocytic lesions on two occasions. Diagnoses were categorized into one of five classes according to the MPATH-Dx© system...
March 7, 2018: Journal of the American Academy of Dermatology
Stephanie J Sexton, Michael A Granieri, Aaron C Lentz
BACKGROUND: Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. AIM: To evaluate surgeon practices in the management of intraoperative urethral injury. METHODS: An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA)...
March 6, 2018: Journal of Sexual Medicine
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