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https://www.readbyqxmd.com/read/27933209/prevalence-and-incidence-of-gout-in-southern-sweden-from-the-socioeconomic-perspective
#1
Meliha C Kapetanovic, Mohaned Hameed, Aleksandra Turkiewicz, Tuhina Neogi, Tore Saxne, Lennart Jacobsson, Martin Englund
OBJECTIVES: To estimate the prevalence and cumulative incidence of gout in southern Sweden with respect to socioeconomic status. METHODS: Among residents of Skåne region in the year 2013 (total population 1.3 million), adult persons (age 18 years +) who between 1998 and 2013 received a diagnosis of gout (International Classification of Disease 10th Edition (ICD-10) code M10) by any physician were identified using the Skåne Healthcare Register. We calculated the point prevalence by end of 2013 and annual cumulative incidence in 2013 standardised to the whole Skåne population according to sex, individual information on occupation (white collar/blue collar), income (low/middle/high) and level of education (primary school/high school/university)...
2016: RMD Open
https://www.readbyqxmd.com/read/27933156/improving-the-accuracy-of-electronic-prescribing-in-west-bay-health-center-in-qatar
#2
Wafaa Yousuf, Sheren Elkomy, Mona Soliman, Noof Al-Mansouri, Mohamed Salem, Amal Al-Ali, Mohamed H Mahmoud, Hisham Elmahdi
Primary healthcare in Qatar uses electronic prescribing to reduce the risk of medication errors. Electronic prescribing is supported by computerized Physician Order Entry systems through Cerner (electronic medical record system). There are still prescription errors, despite electronic prescribing being in place for one year at West Bay Health Center. West Bay Health Center is a famous primary healthcare center in Qatar. It is a training center for the family medicine residency program, which is accredited by the accreditation council of general medical education international (ACGME-I)...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#3
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27930369/measuring-moral-distress-among-critical-care-clinicians-validation-and-psychometric-properties-of-the-italian-moral-distress-scale-revised
#4
Giulia Lamiani, Ilaria Setti, Luca Barlascini, Elena Vegni, Piergiorgio Argentero
OBJECTIVES: Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis...
December 7, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#5
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/27928715/the-impaired-anesthesiologist-what-you-should-know-about-substance-abuse
#6
Stefan T Samuelson, Ethan O Bryson
PURPOSE: Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. PRINCIPAL FINDINGS: Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life...
December 7, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27927262/first-successful-pre-distribution-of-stable-iodine-tablets-under-japan-s-new-policy-after-the-fukushima-daiichi-nuclear-accident
#7
Mayo Ojino, Sumito Yoshida, Takashi Nagata, Masami Ishii, Makoto Akashi
Stable iodine tablets are effective in reducing internal exposure to radioactive iodine, which poses a risk for thyroid cancer and other conditions. After the Fukushima Daiichi nuclear power plant accident, the Japanese government shifted its policy on stable iodine tablet distribution from "after-the-fact" to "before-the-fact" and instructed local governments to pre-distribute stable iodine tablets to residents living within a 5-km radius of nuclear facilities. The nation's first pre-distribution of stable iodine tablets was carried out in June and July of 2014 in Kagoshima Prefecture...
December 8, 2016: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#8
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27925077/challenges-to-implementation-of-advance-directives-of-will-in-hospital-practice
#9
Silvana Bastos Cogo, Valéria Lerch Lunardi, Alberto Manuel Quintana, Nara Marilene Oliveira Girardon-Perlini, Rosemary Silva da Silveira
Objective: to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. Method: qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. Results: the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27924665/behind-closed-doors
#10
Kevin Duan, Leslie Sheu
This Personal View about feedback culture is based on our personal experiences as internal medicine chief residents with attendings, residents, and interns who came into our office to discuss concerns about team members. Our unique perspective as chief residents revealed a tendency amongst physicians at all levels of training to first raise these concerns behind closed doors, instead of with the learner directly. We highlight the need to shift feedback culture in medical training away from this practice towards a clinical "micro-coaching" approach...
December 7, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27923396/how-we-read-fch-pet-ct-for-prostate-cancer
#11
REVIEW
Jean-Mathieu Beauregard, Alexis Beaulieu
Over the last decade, (18)F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) has gained in popularity for the staging and restaging of patients with prostate cancer (PCa). However, despite abundant literature on the topic, there is a lack of publications on how to actually interpret FCH-PET/CT in a clinical setting. Here we propose a practical, TNM-oriented approach to read FCH-PET/CT, with notes on procedure technique, image display, review sequence and report structure. The purpose of this article is to provide guidance to radiologists, nuclear medicine physicians and residents who are new to FCH-PET/CT, as well as to propose an alternate approach to more experienced physicians...
December 6, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
https://www.readbyqxmd.com/read/27922990/robotically-assisted-thoracic-surgery-proposed-guidelines-for-privileging-and-credentialing
#12
Faiz Y Bhora, Adnan M Al-Ayoubi, Sadiq S Rehmani, Craig M Forleiter, Wissam N Raad, Scott G Belsley
OBJECTIVE: Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. METHODS: We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery...
December 5, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922718/costly-and-unnecessary
#13
Kate Harrington
Many U.S. medical students, residents, and physicians want to see the elimination of the U.S. Medical Licensing Exam Step 2 Clinical Skills exam, saying it has a high price tag and an even higher first-attempt pass rate.
December 1, 2016: Texas Medicine
https://www.readbyqxmd.com/read/27922121/sex-differences-in-prevalence-of-and-risk-factors-for-carotid-plaque-among-adults-a-population-based-cross-sectional-study-in-rural-china
#14
Wei Zhao, Yanan Wu, Min Shi, Lingling Bai, Jun Tu, Zaiyu Guo, Rongcai Jiang, Jianning Zhang, Xianjia Ning, Jinghua Wang
Although the associations between carotid plaque and cardiovascular disease risk factors have been identified in previous studies, there is limited information on sex-related differences in factors associated with the development of carotid plaque. We aimed to determine sex differences in the prevalence of carotid plaque and associated risk factors in rural China. A total of 3,789 subjects aged ≥45 years without history of stroke or cardiovascular disease were recruited to the study. B-mode ultrasonography was performed to determine the presence of carotid plaque...
December 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27919374/the-m-health-revolution-exploring-perceived-benefits-of-whatsapp-use-in-clinical-practice
#15
Kurubaran Ganasegeran, Pukunan Renganathan, Abdul Rashid, Sami Abdo Radman Al-Dubai
BACKGROUND: The dawn of m-Health facilitates new horizons of professional communication through WhatsApp, allowing health professionals to interact fast and efficiently for effective patient management. This preliminary study aimed to investigate perceived benefits, if any, of WhatsApp use across general medical and emergency teams during clinical practice in Malaysia. METHODS: A cross-sectional study was conducted in a universal sample of 307 health professionals comprising of nurses, medical assistants, medical residents, medical officers and physicians across medical and casualty departments in a Malaysian public hospital...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918408/full-practice-authority-for-nurse-practitioners
#16
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#17
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27909542/which-factors-influence-resident-physicians-to-prescribe-noacs-to-patients-with-non-valvular-atrial-fibrillation
#18
Zardasht Oqab Md Frcpc, William F McIntyre Md Frcpc, Wilma M Hopman Ma, Adrian Baranchuk Md Facc Frcp
The Canadian Cardiovascular Society and the European Society of Cardiology recommend the use of non-vitamin K antagonists (NOAC) in preference to warfarin for stroke prevention in most patients with non-valvular atrial fibrillation (AF). The aim of this study was to identify factors that predict selection of a NOAC by resident physicians when faced with patients with non-valvular AF. A web-based survey was distributed to residents across Canada to learn the attitudes and behaviours regarding stroke, bleeding risk and choices of therapy in different clinical scenarios involving the same patient and one additional co-morbidity...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907128/fasa-registry-on-acute-myocardial-infarction-farmi-feasibility-study-and-pilot-phase-results
#19
Ehsan Bahramali, Alireza Askari, Habib Zakeri, Mojtaba Farjam, Azizallah Dehghan, Kazem Zendehdel
BACKGROUND: Myocardial infarction (MI) is the leading cause of death in Iran. Every attempt to improve treatment patterns and patient outcomes needs a surveillance system to both consider the efficacy and safety measures. Fasa Registry on Myocardial Infarction (FaRMI) is the first population-based registry for acute MI in Iran targeted to provide meticulous description of patients' characteristics, to explore the management patterns of these patients, to discover the degree of adherence to the practice guidelines, and to investigate the determinants of poor in-hospital and later outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#20
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
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