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Continual medical education

Emilie Venables, Jeffrey K Edwards, Saar Baert, William Etienne, Kelly Khabala, Helen Bygrave
INTRODUCTION: The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care...
2016: PloS One
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
(no author information available yet)
No abstract text is available yet for this article.
November 2016: Anesthesiology
Paul B Perrin, Lillian F Stevens, Megan Sutter, Anthony H Lequerica, Denise Krch, Stephanie A Kolakowsky-Hayner, Juan Carlos Arango-Lasprilla
OBJECTIVE: The research attempting to disentangle the directionality of relationships between mental health and functional outcomes after traumatic brain injury (TBI) is growing but has yielded equivocal findings or focused on isolated predictors or isolated outcomes. The purpose of the current study was to use cross-lagged panel and structural equation modeling (SEM) techniques to examine causality between comprehensive indices of mental health (depression, anxiety, and life satisfaction) and functional independence in a national sample of individuals with TBI over the first 2 years after injury...
October 13, 2016: American Journal of Physical Medicine & Rehabilitation
Cheol Ho Kim
On the occasion of ISH 2016 Seoul, which includes the APSH meeting, as the president of APSH, I will briefly summarize the important points in the management of hypertension from the experience in the past 20 years in Korea.I emphasize 4 areas to be improved in hypertension management.The first is how to correctly diagnose hypertension, which should be done by employing out of office BP measurement. In Korea, these modalities are underutilized.The second is how to increase the awareness rate in hypertension...
September 2016: Journal of Hypertension
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Fernando Stuardo Wyss Quintana
Latin America has 23 countries ranging from Mexico, Central America, South America and the Caribbean, of these 19 countries are considered by the WHO as countries with high and very high risk, one of the similarities of our countries is poor access to services health and medicine, resulting from poor government investment in health as the amount used in this sector occupies only the best 3% of the national budget and gross domestic product.Thus we know that the prevalence of hypertension varies widely from country to country and from city to city, presenting in Guatemala a prevalence of 40%, while in other countries in the area ranges between 25 and 35%, most complicated problem is that within the same country as the population this prevalence can vary greatly and have a different impact between populationsTherefore we know that the impact of cardiovascular disease within the range of non-communicable diseases occupies at least 30% and of these about 70% occupied countries of low and moderate income...
September 2016: Journal of Hypertension
Steven L Clark, Emily Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
Manuela Casula, Lorenza Scotti, Elena Tragni, Luca Merlino, Giovanni Corrao, Alberico L Catapano
BACKGROUND AND AIMS: We aimed at describing the therapeutic approach in young adult patients diagnosed with heterozygous familial hypercholesterolemia (HeFH) and their adherence and persistence to treatment. METHODS: From regional administrative databases, individuals aged ≤40 years, who received exemption for HeFH between January 1, 2003 and December 31, 2011, and concomitantly started statin treatment, were identified. Within the first year of treatment, we evaluated therapeutic changes, adherence as MPR (medication possession ratio), persistence as continuous drug coverage without gaps ≥60 days, and influencing factors using log binomial models...
October 12, 2016: Atherosclerosis
Josune Martín, Fernando Torre, Urko Aguirre, Angel Padierna, Begoña Matellanes, José M Quintana
OBJECTIVE: Fibromyalgia is a chronic pain disorder with a range of comorbid symptoms, including anxiety. We aimed to prospectively identify predictors of the long-term impact of fibromyalgia on health-related quality of life after the end of an interdisciplinary intervention. METHODS: 138 patients with fibromyalgia, selected from a hospital pain management unit, participated in a 6-week interdisciplinary treatment that combined coordinated psychological, medical, educational, and physiotherapeutic interventions...
October 11, 2016: Journal of Affective Disorders
Jeniece Trast Ilkowitz, Steven Choi, Michael L Rinke, Kathy Vandervoot, Rubina A Heptulla
BACKGROUND: Diabetes ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM). Reducing DKA admissions in children with T1DM requires a coordinated, comprehensive management plan. We aimed to decrease DKA admissions, 30-day readmissions, and length of stay (LOS) for DKA admissions. METHODS: A multipronged intervention was designed in 2011 to reach all patients: (1) increase insulin pump use and basal-bolus regimen versus sliding scales, (2) transform educational program, (3) increased access to medical providers, and (4) support for patients and families...
October 2016: Quality Management in Health Care
Cécile M Yelnik, Monica Richey, Virginia Haiduc, Sotiria Everett, Meng Zhang, Doruk Erkan
OBJECTIVE: To determine if a cardiovascular disease prevention (CVD) counseling program for lupus patients decreases the prevalence of CVD risk factors. METHODS: The assessment phase of three-year CVD prevention counseling program included the evaluation of CVD risk factors, diet, exercise habits, and medications. The education phase included discussion of the above risk factors as well as CVD and thrombosis prevention strategies. Patients were prospectively followed every 3-6 months for risk assessment and continued education by a nurse practitioner and a medical doctor...
October 16, 2016: Arthritis Care & Research
Tamar Sapir, Erica Rusie, Laurence Greene, Jinoos Yazdany, Mark L Robbins, Eric M Ruderman, Jeffrey D Carter, Barry Patel, Kathleen Moreo
INTRODUCTION: In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits...
December 2015: Rheumatol Ther
Mandira Paul, Sharad D Iyengar, Birgitta Essén, Kristina Gemzell-Danielsson, Kirti Iyengar, Johan Bring, Marie Klingberg-Allvin
BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion...
October 17, 2016: BMC Public Health
Julie R Taylor, Pamela J Thompson, Jonathan R Genzen, John Hickner, Marisa B Marques
BACKGROUND: The 2015 Institue of Medicine report Improving Diagnosis in Health Care highlighted that diagnostic errors cause patient harm and that improvement in the diagnostic process requires better collaboration among physicians and laboratory professionals. The purpose of this study is to understand why physicians do not contact laboratory professionals when facing diagnostic challenges and identify opportunities for laboratory professionals to become more recognized members of the clinical care team...
October 15, 2016: Laboratory Medicine
Elizabeth T Gershoff, Sarah A Font, Catherine A Taylor, Rebecca H Foster, Ann Budzak Garza, Denyse Olson-Dorff, Amy Terreros, Monica Nielsen-Parker, Lisa Spector
Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e...
October 13, 2016: Child Abuse & Neglect
Víctor Daniel Rosenthal, Hail M Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S G Buenaflor, Michael M Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos
BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days...
October 11, 2016: American Journal of Infection Control
Rachel V van Schendel, Lieve Page-Christiaens, Lean Beulen, Catia M Bilardo, Marjon A de Boer, Audrey B C Coumans, Brigitte H Faas, Irene M van Langen, Klaske D Lichtenbelt, Merel C van Maarle, Merryn V E Macville, Dick Oepkes, Eva Pajkrt, Lidewij Henneman
OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing. METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice...
October 14, 2016: Prenatal Diagnosis
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Transfusion
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
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