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https://www.readbyqxmd.com/read/28440999/-epistemic-injustice-during-the-medical-education-process-in-the-hospital-context
#1
Carolina Consejo-Y Chapela, Carlos Alfonso Viesca-Treviño
BACKGROUND: The educational model adopted by the Universidad Nacional Autónoma de México (UNAM) Faculty of Medicine is constructivist; it is a model based on competence development. It aims to provide learning environments that incorporate real activities (it helps the students to develop social negotiation skills, as part of their integral learning; it encourages them to take a critical and reflexive approach; and it is also a student-centered model). However, many challenges arise when this model is implemented in the context of hospital environments...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28439135/assessment-of-direct-oral-anticoagulant-prescribing-and-monitoring-pre-and-post-implementation-of-a-pharmacy-protocol-at-a-community-teaching-hospital
#2
Christina Miele, Mary Taylor, Aditi Shah
Background: Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective: The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28435756/identifying-barriers-in-the-use-of-electronic-health-records-in-hawai-i
#3
Faith D Hamamura, Kelley Withy, Kira Hughes
Hawai'i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai'i is limited. To address this gap, this article examines the current state of EHR in Hawai'i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai'i's people...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28421425/the-role-of-alaska-s-tribal-health-workers-in-supporting-families
#4
Miriam Chernoff, Katie Cueva
Alaska's Community Health Aides/Practitioners (CHA/Ps) are often the sole medical workers in their communities in rural Alaska, and are instrumental in providing healthcare services and education to otherwise underserved individuals. This qualitative study explored how CHA/Ps support healthy families. Six CHA/Ps from two rural communities in western Alaska were interviewed about their scope of practice, interactions with mothers, infants, families, and teens, relationship to other medical providers, and perceptions of their work...
April 18, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28415972/community-based-survey-during-rabies-outbreaks-in-rangjung-town-trashigang-eastern-bhutan-2016
#5
Tenzin Tenzin, Jamyang Namgyal, Sangay Letho
BACKGROUND: Rabies is a highly fatal disease transmitted through the bite of a rabid animal. Human deaths can be prevented by prompt administering of rabies vaccine and rabies immunoglobulin following the exposure. An assessment of community knowledge, awareness and practices on rabies is important during outbreak to understand their preparedness and target educational messages and response activities by the rapid response team. METHODS: A rabies outbreak has occurred in Rangjung town, eastern Bhutan on 4 October 2016...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28414406/residency-training-in-family-medicine-a-history-of-innovation-and-program-support
#6
Peter J Carek, Tanya Anim, Colleen Conry, Sam Cullison, Stan Kozakowski, Dan Ostergaard, Stacy Potts, Perry A Pugno
Residency programs have been integral to the development, expansion and progression of family medicine as a discipline. Three reports formed the foundation for graduate medical education in family medicine: Meeting the Challenge of Family Practice, The Graduate Education of Physicians, and Health is a Community Affair. In addition, the original core concepts of comprehensiveness, coordination, continuity, and patient centeredness continue to serve as the foundation for residency training in family medicine...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28410366/brief-educational-interventions-to-improve-performance-on-novel-quality-metrics-in-ambulatory-settings-in-kenya-a-multi-site-pre-post-effectiveness-trial
#7
Robert Ryan Korom, Stephanie Onguka, Peter Halestrap, Maureen McAlhaney, Mary Adam
BACKGROUND: The quality of primary care delivered in resource-limited settings is low. While some progress has been made using educational interventions, it is not yet clear how to sustainably improve care for common acute illnesses in the outpatient setting. Management of urinary tract infection is particularly important in resource-limited settings, where it is commonly diagnosed and associated with high levels of antimicrobial resistance. We describe an educational programme targeting non-physician health care providers and its effects on various clinical quality metrics for urinary tract infection...
2017: PloS One
https://www.readbyqxmd.com/read/28406883/characteristics-of-fentanyl-overdose-massachusetts-2014-2016
#8
Nicholas J Somerville, Julie O'Donnell, R Matthew Gladden, Jon E Zibbell, Traci C Green, Morgan Younkin, Sarah Ruiz, Hermik Babakhanlou-Chase, Miranda Chan, Barry P Callis, Janet Kuramoto-Crawford, Henry M Nields, Alexander Y Walley
Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The proportion of opioid overdose deaths in the state involving fentanyl, a synthetic, short-acting opioid with 50-100 times the potency of morphine, increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law enforcement fentanyl seizures in Massachusetts, much of which was believed to be illicitly manufactured fentanyl (IMF) (4)...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28403822/provider-and-patient-perspectives-on-opioids-and-alternative-treatments-for-managing-chronic-pain-a-qualitative-study
#9
Lauren S Penney, Cheryl Ritenbaugh, Lynn L DeBar, Charles Elder, Richard A Deyo
BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. METHODS: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14)...
March 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28396108/augmented-nurse-care-management-in-ckd-stages-4-to-5-a%C3%A2-randomized-trial
#10
Steven Fishbane, Sofia Agoritsas, Alessandro Bellucci, Candice Halinski, Hitesh H Shah, Vipul Sakhiya, Leah Balsam
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients. STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial. SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28384893/a-study-on-gender-preference-and-awareness-regarding-prenatal-sex-determination-among-antenatal-women-in-a-rural-area-of-darjeeling-district-west-bengal-india
#11
Archak Roy, Romy Biswas
INTRODUCTION: Sex ratio is one of the major indicators to find the gender preferences in the community. Change in sex ratio reflects underlying socioeconomic, cultural patterns of a society. AIM: The present study was conducted with the aim to find out the knowledge of antenatal women regarding the prenatal sex determination and the Pre Natal Diagnostic Techniques (PNDT) Act in a rural area along with assessing the gender preference in family among the study population...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28373247/practices-and-attitudes-of-doctors-and-patients-to-downward-referral-in-shanghai-china
#12
Wenya Yu, Meina Li, Xin Nong, Tao Ding, Feng Ye, Jiazhen Liu, Zhixing Dai, Lulu Zhang
OBJECTIVES: In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. METHODS: Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28369066/socioeconomic-factors-explain-suboptimal-adherence-to-antiretroviral-therapy-among-hiv-infected-australian-adults-with-viral-suppression
#13
Krista J Siefried, Limin Mao, Stephen Kerr, Lucette A Cysique, Thomas M Gates, John McAllister, Anthony Maynard, John de Wit, Andrew Carr
BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on ART with undetectable viral load (UDVL) were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs...
2017: PloS One
https://www.readbyqxmd.com/read/28361049/programs-and-place-risk-and-asset-mapping-for-fall-prevention
#14
Matthew Lee Smith, Samuel D Towne, Audry S Motlagh, Donald R Smith, Ali Boolani, Scott A Horel, Marcia G Ory
Identifying ways to measure access, availability, and utilization of health-care services, relative to at-risk areas or populations, is critical in providing practical and actionable information to key stakeholders. This study identified the prevalence and geospatial distribution of fall-related emergency medical services (EMS) calls in relation to the delivery of an evidence-based fall prevention program in Tarrant County, Texas over a 3-year time period. It aims to educate public health professionals and EMS first respondents about the application of geographic information system programs to identify risk-related "hot spots," service gaps, and community assets to reduce falls among older adults...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28353506/a-foundation-for-vital-academic-and-social-support-in-clerkships-learning-through-peer-continuity
#15
Calvin L Chou, Arianne Teherani
Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28346619/scope-of-practice-and-family-medicine-match-rates-results-from-a-cera-clerkship-directors-survey
#16
David Anthony, Jordan White, Katherine Margo, Derjung M Tarn
BACKGROUND AND OBJECTIVES: Family medicine clerkship directors depend on community preceptors to teach and attract medical students to family medicine. Many community preceptors do not provide the full range of family medicine services, and some are not family physicians. This study aimed to determine the types of practices in which family medicine clerkship students train and whether scope of practice is associated with family medicine Match rates. METHODS: Data were collected as part of the 2014 Council of Academic Family Medicine Educational Research Alliance (CERA) Family Medicine Clerkship Director Survey...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#17
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28340544/understanding-challenges-strategies-and-the-role-of-support-networks-in-medication-self-management-among-patients-with-type-2-diabetes
#18
Gerda Bernhard, Dominik Ose, Ines Baudendistel, Hanna M Seidling, Marion Stützle, Joachim Szecsenyi, Michel Wensing, Cornelia Mahler
Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen...
April 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28335820/exploring-the-tensions-of-being-and-becoming-a-medical-educator
#19
Ahsan Sethi, Rola Ajjawi, Sean McAleer, Susie Schofield
BACKGROUND: Previous studies have identified tensions medical faculty encounter in their roles but not specifically those with a qualification in medical education. It is likely that those with postgraduate qualifications may face additional tensions (i.e., internal or external conflicts or concerns) from differentiation by others, greater responsibilities and translational work against the status quo. This study explores the complex and multi-faceted tensions of educators with qualifications in medical education at various stages in their career...
March 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28333613/collaborative-management-of-neurocognitive-disorders-in-primary-care-explorations-of-an-attempt-at-culture-change
#20
Lewis Mehl-Madrona, Barbara Mainguy
INTRODUCTION: Minor neurocognitive disorder (MiND; previously mild cognitive impairment) is a transitional zone between normal cognitive function and early stages of major neurocognitive disorder (previously called dementia). Of people with MiND, 5% to 10% progress to major neurocognitive disorder. Simple interventions such as memory activities, balance exercises, and anti-inflammatory diets have been shown to improve cognitive ability. Also, education and support in group settings have proved beneficial for patients with MiND...
2017: Permanente Journal
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