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Louis B Jones, Sameer Goel, Leroy Y Hung, Matthew L Graves, Clay A Spitler, George V Russell, Patrick F Bergin
The mission of any academic orthopaedic training program can be divided into 3 general areas of focus: clinical care, academic performance, and research. Clinical care is evaluated on clinical volume, patient outcomes, patient satisfaction, and becoming increasingly focused on data-driven quality metrics. Academic performance of a department can be used to motivate individual surgeons, but objective measures are used to define a residency program. Annual in-service examinations serve as a marker of resident knowledge base, and board pass rates are clearly scrutinized...
April 2018: Journal of Orthopaedic Trauma
Sean M Murphy, Jared A Leff, Benjamin P Linas, Jake R Morgan, Kathryn McCollister, Bruce R Schackman
BACKGROUND: Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances...
March 20, 2018: Substance Abuse
Jennifer Bido, Roya Ghazinouri, Jamie E Collins, Desirée Diez Portela, Luis Alcantara, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually. However, these missions have received little critical evaluation. This paper describes the research program Operation Walk (Op-Walk) Boston, and proposes an evaluation model for similar surgical missions. METHODS: We propose an evaluation model, borrowing from the work of Donabedian and enriched by evidence from our research program...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Adel Alharf, Nasser Alqahtani, Ghazi Saeed, Ali Alshahrani, Mubarak Alshahrani, Nasser Aljasser, Mohammed Alquwaizani, Saleh Bawazir
Pharmacovigilance is vital to public health. Adopting a robust spontaneous reporting system for adverse drug events can counteract most hazards that arise from utilizing medicinal products. Prior to the establishment of the Saudi Food and Drug Authority (SFDA), the number of pharmacovigilance-related activities in Saudi Arabia was limited. In 2009, the SFDA established the National Pharmacovigilance and Drug Safety Center (Saudi Vigilance). The pharmacovigilance system has remarkably improved during the past few years...
March 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Anna R Schoenbrunner, Kristen D Kelley, Taylor Buckstaff, Joyce K McIntyre, Alicia Sigler, Amanda A Gosman
BACKGROUND AND PURPOSE: Mexican cleft surgeons provide multidisciplinary comprehensive cleft lip and palate care to children in Mexico. Many Mexican cleft surgeons have extensive experience with foreign, visiting surgeons. The purpose of this study was to characterize Mexican cleft surgeons' domestic and volunteer practice and to learn more about Mexican cleft surgeons' experience with visiting surgeons. METHODS: A cross-sectional validated e-mail survey tool was sent to Mexican cleft surgeons through 2 Mexican plastic surgery societies and the Asociación Mexicana de Labio y Paladar Hendido y Anomalías Craneofaciales, the national cleft palate society that includes plastic and maxillofacial surgeons who specialize in cleft surgery...
March 16, 2018: Annals of Plastic Surgery
Wudan Yan
In early September 2017, when the rains from Hurricane Harvey finally subsided in Houston, Texas, Seth Pedersen loaded up his pickup truck with sample collection kits, waders, rubber boots, buckets, and a small aluminum fishing boat. On that particular day, Pedersen, a second-year graduate student in environmental engineering at Rice University, was-along with a fellow graduate student-on a mission to test the water in homes flooded by Hurricane Harvey. He was looking specifically for E. coli bacteria, chemicals, heavy metals, and other pathogens (Figure 1)...
March 2018: IEEE Pulse
Jun-Hua Zhang, You-Ping Li, Bo-Li Zhang
The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Nancy L Chabot, Evangela E Shread, John K Harmon
There is strong evidence that Mercury's polar deposits are water ice hosted in permanently shadowed regions. In this study, we present new Arecibo radar observations of Mercury's south pole, which reveal numerous radar-bright deposits and substantially increase the radar imaging coverage. We also use images from MESSENGER's full mission to determine the illumination conditions of Mercury's south polar region at the same spatial resolution as the north polar region, enabling comparisons between the two poles...
February 2018: Journal of Geophysical Research. Planets
Raimund Lechner, Thomas Küpper, Markus Tannheimer
INTRODUCTION: History is full of examples of the influence of the mountain environment on warfare. The aim of this article is to identify the main environmental hazards and summarize countermeasures to mitigate the impact of this unique environment. METHODS: A selective PubMed and Internet search was conducted. Additionally, we searched bibliographies for useful supplemental literature and included the recommendations of the leading mountain medicine and wilderness medicine societies...
March 15, 2018: Wilderness & Environmental Medicine
Armel Rivallan
The Abri côtier-Urgence Femmes is an association in Concarneau, Brittany, which helps victims of domestic abuse, by offering them shelter and support, 24/7. A former psychiatric nurse and manager, Edith Rivet volunteers for the association, and shares with us her commitment to the cause.
March 2018: Soins. Psychiatrie
Alessandro L Colosio, S Pogliaghi
INTRODUCTION: Performance during army loaded runs provides a synthetic indicator of a soldier's capacity to move while carrying loads and thereby remain able to execute a mission. The aim of this study was to estimate and compare the energy expenditure (EE) of army loaded runs, conducted in a field environment using laboratory-based equations and HR index (HRindex ). METHODS: 45 Ranger recruits had HR monitored during three loaded runs (10, 15 and 20 km) in full military equipment in the field environment...
March 17, 2018: Journal of the Royal Army Medical Corps
Alexander J M Dingemans, Wilfried Krois, Juan Craniotis Rios, Richard J Wood, Marc A Levitt, Carlos A Reck-Burneo
BACKGROUND/PURPOSE: We conduct an annual medical mission to Hospital Ruth Paz para Niños Quemados y Cirugía Pediátrica in Honduras to operate on cases of anorectal malformations (ARM). To improve our knowledge of these patients, we compared their health-related quality of life (HRQoL), and the health literacy of their caregivers from this hospital and ours in the United States. METHODS: The BRIEF Health Literacy Screen (BHLS) and Pediatric Quality of Life Inventory 4...
February 23, 2018: Journal of Pediatric Surgery
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
Nicholas Bowler, Ceri Phillips, Paul Rees
In the United Kingdom (UK) the prison population has increased by around one third since the turn of the millennium amid growing concern over the correctional mission of prisons, the number of prisoners exhibiting mental health difficulties and high levels of recidivism. This study aims to explore the relationship between 'imported' (pre-prison) factors and prisoner mental health status. Prisoners (N = 756) from two UK prisons completed an established measure of mental health (General Health Questionnaire: GHQ-12) and a bespoke survey on pre-prison characteristics and experiences (for example, dispositions, childhood abuse, substance misuse, learning difficulties and employment)...
March 2018: International Journal of Law and Psychiatry
James Rourke, Shabnam Asghari, Oliver Hurley, Mohamed Ravalia, Michael Jong, Wanda Parsons, Norah Duggan, Katherine Stringer, Danielle O'Keefe, Scott Moffatt, Wendy Graham, Carolyn Sturge Sparkes, Janelle Hippe, Kristin Harris Walsh, Donald McKay, Asoka Samarasena
CONTEXT: This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners...
March 2018: Rural and Remote Health
N Sato, Z Yoshida
Topological constraints on a dynamical system often manifest themselves as breaking of the Hamiltonian structure; well-known examples are nonholonomic constraints on Lagrangian mechanics. The statistical mechanics under such topological constraints is the subject of this study. Conventional arguments based on phase spaces, Jacobi identity, invariant measure, or the H theorem are no longer applicable since all these notions stem from the symplectic geometry underlying canonical Hamiltonian systems. Remembering that Hamiltonian systems are endowed with field tensors (canonical 2-forms) that have zero helicity, our mission is to extend the scope toward the class of systems governed by finite-helicity field tensors...
February 2018: Physical Review. E
Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
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