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Principals of medical education

Tim Blake, Andrew Whallett
Medical registrars have been described as the 'workhorses' of National Health Service hospitals, being at the interface of acute and chronic health services. They are expected to demonstrate effective leadership skills. There are concerns from the Royal College of Physicians that medical registrars are being overwhelmed and unsupported by organisations, and are struggling in their ability to provide safe, high-quality patient care. Junior colleagues are also being deterred by general medical specialties by the prospect of becoming the 'Med Reg'...
October 5, 2016: Postgraduate Medical Journal
María Julieta Russo, Gabriela Cohen, Patricio Chrem Mendez, Jorge Campos, Federico E Nahas, Ezequiel I Surace, Silvia Vazquez, Deborah Gustafson, Salvador Guinjoan, Ricardo F Allegri, Gustavo Sevlever
PURPOSE: Argentina-Alzheimer's Disease Neuroimaging Initiative (Arg-ADNI) is the first ADNI study to be performed in Latin America at a medical center with the appropriate infrastructure. Our objective was to describe baseline characteristics and to examine whether biomarkers related to Alzheimer's disease (AD) physiopathology were associated with worse memory performance. PATIENTS AND METHODS: Fifteen controls and 28 mild cognitive impairment and 13 AD dementia subjects were included...
2016: Neuropsychiatric Disease and Treatment
Anas M A Salim, Bashir Elgizoli
OBJECTIVES: The principal aim of this study was to explore the perspectives of community pharmacists in Khartoum State, Sudan about why they dispense antibiotics without prescription, and to understand their opinions about why they think patients self-medicate. METHODS: This was a qualitative exploratory interview study. Individual, in-depth face-to-face interviews were conducted with a convenience sample of 30 community pharmacists working in Khartoum State, Sudan in the period from May to June 2015...
September 28, 2016: International Journal of Pharmacy Practice
Amal Samir Sedrak, Yasmine Samir Galal, Tarek Tawfik Amin
BACKGROUND: Increasing knowledge and awareness of cancer screening significantly influence health promotion behavior which could markedly reduce incidence rates. In many countries, health care providers are the principal source of information concerning cancer screening. This study was carried out to assess the level of knowledge concerning cancer screening among medical students, house officers and residents and to explore their attitude towards cancer screening practices. MATERIALS AND METHODS: This cross-sectional study was conducted in Kasr Al Ainy Medical School at Cairo University in Egypt, with 300 undergraduate medical students and 150 postgraduates (interns and residents) enrolled...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Cai Le, Su Rong, You Dingyun, Cui Wenlong
BACKGROUND: This study examines how socioeconomic factors are associated with prevalence and self-management of diabetes among ethnic minority groups in the rural Yunnan province, which has the most ethnic minority groups per province in southwest China. METHODS: A cross-sectional survey was carried out in 2014 in a rural southwest population consisting of 5532 consenting individuals aged ⩾35years. Information about participants' demographic characteristics, as well as diabetes diagnosis, treatment, and self-management behaviors, were obtained using a standard questionnaire...
August 31, 2016: Diabetes Research and Clinical Practice
Adam Skinner, Alys Havard, Duong Thuy Tran, Louisa R Jorm
INTRODUCTION: The principal aim of this study was to assess the accessibility of subsidized cessation medications to socioeconomically disadvantaged smokers, including smokers living in regional and remote communities. METHODS: Analyses used baseline questionnaire and linked Pharmaceutical Benefits Scheme data for 18 686 regular smokers participating in the 45 and Up Study, a large-scale Australian cohort study of people aged 45 years and older. Participants who were dispensed nicotine replacement therapy, varenicline, or bupropion were identified from the Pharmaceutical Benefits Scheme data, which provide an essentially complete record of participants' access to subsidized pharmaceuticals...
August 1, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Patrick J Polsunas, Gwendolyn Sowa, Julie M Fritz, Angela Gentili, Natalia E Morone, Srinivasa Naga Raja, Eric Rodriguez, Kenneth Schmader, Joel D Scholten, Debra K Weiner
OBJECTIVE: To present an algorithm of sequential treatment options for managing sacroiliac joint (SIJ) pain in the setting of chronic low back pain (CLBP) in the older adult. This is the tenth part in a series, and includes an illustrative clinical case. METHODS: The stepped care drug table and evaluation and treatment algorithm were created following a thorough literature review of approaches and subsequent analysis through a modified Delphi process. The principal investigator developed the initial draft, which was refined for content by an interdisciplinary panel of five experts...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Paul Worley, Ian Couper, Roger Strasser, Lisa Graves, Beth-Ann Cummings, Richard Woodman, Pamela Stagg, David Hirsh
CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies...
September 2016: Medical Education
Ron L Mason, Michael J Annear, Amanda Lo, Fran McInerney, Laura T Tierney, Andrew L Robinson
BACKGROUND: International evidence suggests that dementia is under-diagnosed in the community and that General Practitioners (GPs) are often reluctant to engage to their fullest capability with patients who exhibit cognitive symptoms. This is potentially reflected by a lack of GP knowledge about the syndrome. However, it is also recognised that attitudes and confidence are important in relation to how and to what extent a GP approaches a person with dementia. This research sought to develop a reliable and valid measure of GPs attitudes and confidence towards dementia...
2016: BMC Family Practice
Adelina Alcorta-Garza, Montserrat San-Martín, Roberto Delgado-Bolton, Jorge Soler-González, Helena Roig, Luis Vivanco
CONTEXT: Medical educators agree that empathy is essential for physicians' professionalism. The Health Professional Version of the Jefferson Scale of Empathy (JSE-HP) was developed in response to a need for a psychometrically sound instrument to measure empathy in the context of patient care. Although extensive support for its validity and reliability is available, the authors recognize the necessity to examine psychometrics of the JSE-HP in different socio-cultural contexts to assure the psychometric soundness of this instrument...
2016: Frontiers in Psychology
Caragh Brosnan, Erica Southgate, Sue Outram, Heidi Lempp, Sarah Wright, Troy Saxby, Gillian Harris, Anna Bennett, Brian Kelly
CONTEXT: Students from backgrounds of low socio-economic status (SES) or who are first in family to attend university (FiF) are under-represented in medicine. Research has focused on these students' pre-admission perceptions of medicine, rather than on their lived experience as medical students. Such research is necessary to monitor and understand the potential perpetuation of disadvantage within medical schools. OBJECTIVES: This study drew on the theory of Bourdieu to explore FiF students' experiences at one Australian medical school, aiming to identify any barriers faced and inform strategies for equity...
August 2016: Medical Education
William Martinez, Sigall K Bell, Jason M Etchegaray, Lisa Soleymani Lehmann
PURPOSE: To develop a practical and psychometrically sound set of survey items that measures moral courage for physicians in the context of patient care. METHOD: In 2013, the 731 internal medicine and surgical interns and residents from two northeastern U.S. academic medical centers were invited to anonymously complete a survey about moral courage, empathy, and speaking up about patient safety breaches. RESULTS: Of the eligible participants, 352 (48%) responded...
July 5, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Amanda H Lavan, Paul F Gallagher, Denis O'Mahony
The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission...
2016: Clinical Interventions in Aging
William J Peterson, Laura R Hopson, Sorabh Khandelwal, Melissa White, Fiona E Gallahue, John Burkhardt, Aimee M Rolston, Sally A Santen
INTRODUCTION: This study investigates the impact of the Doximity rankings on the rank list choices made by residency applicants in emergency medicine (EM). METHODS: We sent an 11-item survey by email to all students who applied to EM residency programs at four different institutions representing diverse geographical regions. Students were asked questions about their perception of Doximity rankings and how it may have impacted their rank list decisions. RESULTS: Response rate was 58% of 1,372 opened electronic surveys...
May 2016: Western Journal of Emergency Medicine
Sumedh S Hoskote, Carlos J Racedo Africano, Andrea B Braun, John C O'Horo, Ronaldo A Sevilla Berrios, Theodore O Loftsgard, Kimberly M Bryant, Vivek N Iyer, Nathan J Smischney
With the ever-increasing adoption of shift models for intensive care unit (ICU) staffing, improving shift-to-shift handoffs represents an important step in reducing medical errors. The authors developed an electronic handoff tool integrated within the existing electronic medical record to improve handoffs in an adult ICU. First, stakeholder (staff intensivists, fellows, and nurse practitioners/physician assistants) input was sought to define what elements they perceived as being essential to a quality handoff...
June 20, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
R Buzelé, L Barbier, A Sauvanet, B Fantin
Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Post-splenectomy infections are potentially severe with overwhelming post-splenectomy infection (OPSI) and this justifies preventive measures (prophylactic antibiotics, appropriate immunizations, patient education) and demands prompt antibiotic management with third-generation cephalosporins for any post-splenectomy fever...
August 2016: Journal of Visceral Surgery
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
Faika Zanjani, Rachel Smith, Svetla Slavova, Richard Charnigo, Nancy Schoenberg, Catherine Martin, Richard Clayton
BACKGROUND: Alcohol and medication interactions are projected to increase due to the growth of older adults that are unsafely consuming alcohol and medications. Plus, aging adults who reside in rural areas are at the highest risk of experiencing medication interactions. OBJECTIVE: Estimate concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions. METHODS: Kentucky nonfederal, acute care inpatient hospital discharge electronic records for individuals aged 50+ years from 2001 to 2012 were examined...
July 2016: American Journal of Drug and Alcohol Abuse
L E Fernández-Isla, S Conde-Valvis-Fraga, J S Fernández-Ruíz
OBJECTIVE: To determine the satisfaction of main caregivers of deceased patients followed-up by palliative care teams. METHOD: Web research on electronic data bases: PubMed and MEDES, using "Palliative Care" and "Patient Satisfaction" as main descriptors, and "Family", "Professional-Family Relations", "Quality of Health Care" and "Quality Assurance, Health Care" as secondary descriptors. Studies written in Spanish and English were included. RESULTS: Profile of principal caregiver: a woman between her mid-forties and her mid-fifties, usually related with the patient as a daughter, and of primary educational level...
April 22, 2016: Semergen
Ahna Ballonoff Suleiman, Jessica S Lin, Norman A Constantine
Sexual communication is a principal means of transmitting sexual values, expectations, and knowledge from parents to their children and adolescents. Many parents seek information and guidance to support talking with their children about sex and sexuality. Parent education materials can deliver this guidance but must use appropriate readability levels to facilitate comprehension and motivation. This study appraised the readability of educational materials to support parent sexual communication with their children...
May 2016: Journal of Health Communication
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