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Continual medical education type 2

Scott J Pilla, James R Dotimas, Nisa M Maruthur, Jeanne M Clark, Hsin-Chieh Yeh
AIMS: When patients with type 2 diabetes initiate insulin, metformin should be continued while continuation of other antihyperglycemics has unclear benefit. We aimed to identify practice patterns in antihyperglycemic therapy during the insulin transition, and determine factors associated with metformin continuation. METHODS: We performed a retrospective analysis of the Look AHEAD (Action for Health in Diabetes) trial which randomized overweight/obese adults under ambulatory care for type 2 diabetes to an intensive lifestyle intervention or diabetes support and education...
March 7, 2018: Diabetes Research and Clinical Practice
Tomomi Sato, Masaru Usui, Shigeki Maetani, Yutaka Tamura
The aim of the present study was to determine and compare the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and their molecular characteristics among veterinary staff in Sapporo in 2008 and 2016. We isolated MRSA from veterinarians (Vet; n = 91), veterinary technicians (VT; n = 113), and other staff members (n = 24) from 45 small animal hospitals (animal hospitals), as well as from surface swabs (n = 123) obtained from 37 animal hospitals, in 2016. MRSA was observed in 14 Vets (15%), 7 VTs (6%), 2 other staff members (8%), and 6 environmental samples (5%)...
February 28, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Brian R Wood, Vanessa M McMahan, Kelly Naismith, Jonathan B Stockton, Lori A Delaney, Joanne D Stekler
BACKGROUND: We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. METHODS: In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. RESULTS: Of 735 eligible providers, 64...
January 4, 2018: Sexually Transmitted Diseases
Aditya Yeolekar, Haris Qadri
The learning curve as a concept has been considered, discussed and debated in medical education and healthcare for over two decades. The precise usage has been recognised in surgical disciplines both broad specialties and sub-specialties. Rollin Daniel in his book stated that, rhinoplasty is the most difficult of all cosmetic operations for three reasons, (a) nasal anatomy is highly variable, (b) the procedure must correct form and function and (c) the final result must meet the patients expectations. With this in mind a study was carried on the perception of learning curve in rhinoplasty based on a surgeon questionnaire at Marien Hospital, Stuttgart, Germany under Prof...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Elliot M Ross, Theodore T Redman, Julian G Mapp, Derek J Brown, Kaori Tanaka, Craig W Cooley, Chetan U Kharod, David A Wampler
BACKGROUND: The "Stop the Bleed" campaign advocates for non-medical personnel to be trained in basic hemorrhage control. However, it is not clear what type of education or the duration of instruction needed to meet that requirement. The objective of this study was to determine the impact of a brief hemorrhage control educational curriculum on the willingness of laypersons to respond during a traumatic emergency. METHODS: This "Stop the Bleed" education initiative was conducted by the University of Texas Health San Antonio Office of the Medical Director (San Antonio, Texas USA) between September 2016 and March 2017...
February 19, 2018: Prehospital and Disaster Medicine
Lynden Lindsay Crowshoe, Han Han, Betty Calam, Rita Henderson, Kristen Jacklin, Leah Walker, Michael E Green
INTRODUCTION: Health education about Indigenous populations in Canada (First Nations, Inuit, and Métis people) is one approach to enable health services to mitigate health disparities faced by Indigenous peoples related to a history of colonization and ongoing social inequities. This evaluation of a continuing medical education workshop, to enhance family physicians' clinical approach by including social and cultural dimensions within diabetes management, was conducted to determine whether participation in the workshop improved self-reported knowledge, skills, and confidence in working with Indigenous patients with type 2 diabetes...
February 1, 2018: Journal of Continuing Education in the Health Professions
Michelle Mocarski, Jason Yeaw, Victoria Divino, Mitch DeKoven, German Guerrero, Jakob Langer, Brian Larsen Thorsted
BACKGROUND: Clinical inertia in type 2 diabetes mellitus (T2DM) refers to the failure of clinicians to intensify therapy when indicated. Many T2DM patients remain suboptimally controlled after initiating basal insulin. OBJECTIVE: To examine the prevalence of patients treated with basal insulin but in poor glycemic control (hemoglobin A1c [A1c] ≥ 7%) after initiation and subsequent treatment intensification patterns and glycemic outcomes in a real-world setting...
November 16, 2017: Journal of Managed Care & Specialty Pharmacy
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
May 30, 2017: Journal of Managed Care & Specialty Pharmacy
Sandra Zoni, Marie-Elise Verga, Michael Hauschild, Marie-Paule Aquarone-Vaucher, Teresa Gyuriga, Anne-Sylvie Ramelet, Andrew A Dwyer
PURPOSE: We aimed to evaluate patient self-management activities, patient perceptions of the therapeutic relationship and satisfaction with nurse-led consultations as part of a structured, pilot program transitioning young adults with type 1 diabetes (T1DM) to adult-oriented community-based practices. DESIGN AND METHODS: A descriptive, cross-sectional study of patients receiving nurse-led consultations. Patients provided sociodemographic/health information, glycated hemoglobin (HbA1c) measures and completed questionnaires assessing self-management (Revised Self-Care Inventory) and the therapeutic relationship (Caring Nurse-Patient Interaction - short scale)...
January 2018: Journal of Pediatric Nursing
Misa Adachi, Kazue Yamaoka, Mariko Watanabe, Asuka Nemoto, Toshiro Tango
INTRODUCTION: Type 2 diabetes (T2D) is a significant problem, and lifestyle modifications including self-management are important. We have developed a structured individual-based lifestyle education (SILE) programme for T2D. With attention now being paid to techniques to change behaviour, we recently developed a behavioural type-specific SILE (BETSILE) programme. We aimed to evaluate the effectiveness of the BETSILE programme compared with the SILE programme for reducing glycated haemoglobin (HbA1c) in patients with T2D and special behavioural types by a cluster randomised controlled trial...
October 24, 2017: BMJ Open
Olawale D Olatunbosun, Tonya M Esterhuizen, Charles S Wiysonge
BACKGROUND: In South Africa, influenza vaccination is recommended to all diabetics. However, vaccination coverage among diabetics remains low. Therefore, this study aimed to explore the knowledge, attitudes, and practices among people with diabetes in Pretoria regarding seasonal influenza and influenza vaccination. METHOD: A cross-sectional survey was conducted among type 1 and 2 diabetes mellitus patients who attended diabetic clinics in two major tertiary hospitals in Pretoria, South Africa from October to December 2015...
November 7, 2017: Vaccine
Aki Tsunoda, Yoshifumi Kido, Mami Kayama
AIM: The Japanese Ministry of Health, Labor and Welfare sponsored the current examination of a new community mental health service, the Japan Outreach Model Project (JOMP), for persons with mental illnesses and who find it difficult to continue with ongoing treatment. Shorter readmission rates and hospital stays were found. In this study, the amount and type of care that were delivered by the JOMP were examined in order to inform the process of establishing the public insurance system...
October 9, 2017: Japan Journal of Nursing Science: JJNS
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
Mark R Zonfrillo, Mackenzie L Ramsay, Janette E Fennell, Amber Andreasen
OBJECTIVE: There have been substantial reductions in motor vehicle crash-related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database. METHODS: Instances of non-traffic injuries and fatalities in the United States to children 0-14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication...
September 21, 2017: Traffic Injury Prevention
(no author information available yet)
BACKGROUND: Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level...
November 2017: Lancet Neurology
Rian Adi Pamungkas, Kanittha Chamroonsawasdi, Paranee Vatanasomboon
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control...
September 15, 2017: Behavioral Sciences
Tomas Pantoja, Newton Opiyo, Simon Lewin, Elizabeth Paulsen, Agustín Ciapponi, Charles S Wiysonge, Cristian A Herrera, Gabriel Rada, Blanca Peñaloza, Lilian Dudley, Marie-Pierre Gagnon, Sebastian Garcia Marti, Andrew D Oxman
BACKGROUND: A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness...
September 12, 2017: Cochrane Database of Systematic Reviews
Vandana Ahluwalia, Emmanouil Rampakakis, Mohammad Movahedi, Angela Cesta, Xiuying Li, John S Sampalis, Claire Bombardier
Despite the availability of treatment guidelines and effective treatments, real-world effectiveness remains suboptimal partly due to poor patient medication adherence. We evaluated a comprehensive set of sociodemographic, health insurance, and disease-related factors for association with patient decision to discontinue anti-rheumatic medications (ARMs) in a large observational RA cohort in Ontario, Canada. Patients from the Ontario Best Practices Research Initiative registry were included. The following predictors of ARM discontinuation were evaluated with cox-regression: patient age, gender, education, income, smoking, health insurance type/coverage, RA duration, erosion presence, RF positivity, DAS28-ESR, physician global, HAQ-DI, comorbidity number, ARM types, and physician characteristics (gender, academic position, urban vs...
November 2017: Clinical Rheumatology
Lynden Lindsay Crowshoe, Rita I Henderson, Michael E Green, Kristen M Jacklin, Leah M Walker, Betty Calam
OBJECTIVES: The perspectives of physicians caring for Indigenous patients with diabetes offer important insights into the provision of health-care services. The purpose of this study was to describe Canadian physicians' perspectives on diabetes care of Indigenous patients, a preliminary step in developing a continuing medical education intervention described elsewhere. METHODS: Through in-depth semistructured interviews, Canadian family physicians and specialists with sizeable proportions of Indigenous clientele shared their experiences of working with Indigenous patients who have type 2 diabetes...
August 15, 2017: Canadian Journal of Diabetes
B A Ezeala-Adikaibe, T Okpara, O S Ekenze, O Onodugo, N P Ezeala-Adikaibe, T Nnaji, G Onyebueke
PURPOSE: Though most doctors in their professional life will provide care for people with epilepsy, many will not get further training in their professional life. There may be other barriers, perceived or not, to providing care to people living with epilepsy by doctors which need to be approached in the medical undergraduate curriculum and medical continuing education. The aim of this study was to determine the knowledge gaps of medical students on basic issues regarding epilepsy that could be useful in preparing training material for the students and continuous medical education for doctors working in the community...
July 2017: Nigerian Journal of Clinical Practice
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