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clinical reasoning education

Mulugeta Dile Worke, Lealem Meseret Bezabih, Mulat Adefris Woldetasdik
BACKGROUND: Contraception helps to prevent unplanned pregnancies among human immune virus positive women. The contraceptive utilization status and associated factors were not well addressed in the study area. Therefore, this study aimed to assess utilization of contraceptives and associated factors among human immune virus positive reproductive age group women appearing at anti-retroviral therapy clinic at the University of Gondar Hospital, North West Ethiopia. METHOD: An institution based cross-sectional study was conducted among 397 systematically selected HIV positive reproductive age women who visited ART unit of the University of Gondar teaching referral hospital from January 8-20, 2014...
October 21, 2016: BMC Women's Health
Lyndon G Amorin-Woods, Gregory F Parkin-Smith, Lee Nedkoff, Colleen Fisher
BACKGROUND: This paper reports the quantitative outcomes of a mixed-methods pilot study of the characteristics and demographics of chiropractic practices and patients in Western Australia. METHODS: This was a mixed-methods data transformation model (qualitative to quantitative) pilot study. A non-random sample of chiropractic practices across Western Australia was recruited and data collected anonymously from consecutive new patients using an online platform. Data covered practice and patient demographics and characteristics, alongside quality of life measures...
2016: Chiropractic & Manual Therapies
Denise Dion Hallfors, Bonita J Iritani, Lei Zhang, Shane Hartman, Winnie K Luseno, Elias Mpofu, Simbarashe Rusakaniko
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (Nā€‰=ā€‰35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2007 as all female sixth graders in 25 rural eastern Zimbabwe primary schools whose parents, one or both, had died (Nā€‰=ā€‰328)...
December 2016: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Nirav Patel, Justine Pierson, Timothy Lee, Bruce Mast, Bernard T Lee, Irene Estores, Dhruv Singhal
BACKGROUND: Integrative medicine (IM) is currently used by 40% of Americans. Our objective is to examine the prevalence and perception of IM utilization in patients being evaluated for elective plastic surgery. METHODS: In July 2014, 402 consecutive patients presenting to plastic surgery clinics at the University of Florida, Veterans Affairs (VA), and Private Practices in Gainesville, Florida were requested to complete a survey regarding utilization of and attitudes towards IM...
October 17, 2016: Annals of Plastic Surgery
Ejiofor T Ugwu, Casmir Jg Orjioke, Ekenechukwu E Young
BACKGROUND: Self monitoring of blood glucose (SMBG) is a useful adjunct to lifestyle modification and medications for optimal management of type 2 diabetes mellitus (DM). This study was aimed at evaluating the practice, cost and associations of SMBG in subjects with type 2 DM in Enugu, Nigeria. METHODS: In a cross-sectional survey conducted at the diabetes clinic in three hospitals, 366 type 2 diabetic subjects aged 18-65 years were consecutively interviewed. Socio-demographic and clinical information were documented and glycated hemoglobin was performed for all the participants...
October 14, 2016: Current Diabetes Reviews
Sverre Kjeldsen
There is a whole armament of good drugs for treatment of hypertension including diuretics, calcium antagonist, angiotensin receptor antagonists and angiotensin converting enzyme inhibitors. Secondary drugs mostly used for special indications include beta-blockers, alpha-blockers, mineralocorticoid receptor antagonists (aldosterone antagonists), renin-inhibitors, centrally acting drugs, direct vasodilators and others.A variety of new drugs targeting different pressor mechanism exist and have partly been studies experimentally but will unlikely make it to clinical use in human 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
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
S McDougall, C W R Compton, N Botha
AIMS: To determine the factors associated with the selection of antimicrobials by dairy veterinarians, and the attitudes of those veterinarians and dairy farmers to antimicrobial usage and resistance. METHODS: Facilitated focus groups of dairy farmers (n=22) and an anonymous online survey of dairy cattle veterinarians (n=206 respondents) were used to determine prescribing behaviour, factors affecting prescribing of antimicrobials, and the attitudes of veterinarians and farmers to the use of antimicrobials and the risk of antimicrobial resistance (AMR)...
October 16, 2016: New Zealand Veterinary Journal
Nupur D Shrirao, Saee P Deshmukh, Neelam A Pande, Usha M Radke
INTRODUCTION: For fabricating dental prostheses that meet patients' demands and have good longevity and function, appropriate treatment planning and decision-making are required. Therefore, not only technical skills and clinical judgment of the dentist are needed, but also patients' attitude toward treatment plays a critical role in posttreatment satisfaction. AIM: The aim of this study is to investigate the factors affecting decision-making and the selection of dental prosthesis by the patients...
October 2016: Journal of Indian Prosthodontic Society
Max Bolun Liu, Thuy Bui Huong, Xuyen Hoang, Lan Doan, Shauna Trinh, Hoa Pham Anh Nguyen, Hai Thanh Le, Ai-Xuan Holterman
BACKGROUND: Biliary atresia is an idiopathic, neonatal liver disease of the bile ducts. The natural evolution of biliary atresia is known in developed countries. This study describes the clinical course of biliary atresia in Vietnam, a developing country. METHODS: Chart reviews were undertaken of patients treated with or without the Kasai procedure between January 2010 and July 2013 at a children's hospital in Vietnam. RESULTS: Of 287 children with biliary atresia, 149 (52%) were treated without the Kasai procedure and 138 (48%) were treated with the Kasai procedure...
October 12, 2016: Surgery
Janet Landeen, Donna Carr, Kirsten Culver, Lynn Martin, Nancy Matthew-Maich, Charlotte Noesgaard, Larissa Beney-Gadsby
Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology...
October 4, 2016: Nurse Education in Practice
Hana Alsobayel
BACKGROUND: Social media can be used in health care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. OBJECTIVE: The aim of this study was to explore the use of social media networks for the purpose of professional development among health care professionals in Saudi Arabia using a purpose-designed Web-based survey. METHODS: A cross-sectional web-based survey was undertaken...
September 12, 2016: JMIR Med Educ
Daniela Schoberer, Helena Leino-Kilpi, Helga E Breimaier, Ruud Jg Halfens, Christa Lohrmann
PURPOSE OF THE STUDY: Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. METHODS: A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents...
2016: Clinical Interventions in Aging
Kamlesh Khunti, David Millar-Jones
Achieving tight glycaemic control early following the diagnosis of type 2 diabetes is key to optimising clinical outcomes, yet many patients and clinicians are reluctant to initiate and intensify insulin therapy. Reasons for this arise primarily from a lack of time, clinical expertise and patient understanding. However, meaningful progress can be achieved with self-management educational programmes soon after diagnosis. Clinician education and training, along with easy-to-use and well-tolerated therapies (for example, those carrying a low risk of hypoglycaemia and/or avoiding weight gain), may also increase the likelihood of patient adherence...
October 7, 2016: Primary Care Diabetes
Nancy R Cook, Paul M Ridker
The latest guidelines from the American College of Cardiology and American Heart Association, released in fall 2013, provide a long-anticipated update to the recommendations of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). The guidelines incorporate a new risk score for atherosclerotic cardiovascular disease that includes stroke as well as coronary heart disease. After publication, the new pooled cohort equations (PCEs) were evaluated in 15 studies from the United States and Europe, most of which used cohorts that were more contemporary than those used in developing the guidelines...
October 11, 2016: Annals of Internal Medicine
Rachel Locke, Gail Alexander, Richard Mann, Sharon Kibble, Samantha Scallan
BACKGROUND: Looking beyond dyslexia as an individual doctor's issue requires adjusting a working environment to better serve the needs of doctors with dyslexia. With an increasing number of doctors disclosing dyslexia at medical school, how can educators best provide this support? Our research looks at the impact of dyslexia on clinical practice and the coping strategies used by doctors to minimise the effect. METHODS: Qualitative data were collected from 14 doctors with dyslexia using semi-structured interviews and by survey...
October 6, 2016: Clinical Teacher
Denise E Doomernik, Harry van Goor, Jan G M Kooloos, Richard P Ten Broek
The Radboud University Medical Center has a problem-based, learner-oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students' decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second-year medical students was assessed. In May 2011, 346 medical students applied for the second-year gastro-intestinal (GI) tract course...
October 5, 2016: Anatomical Sciences Education
Mark L Wahlqvist
Food systems have changed markedly with human settlement and agriculture, industrialisation, trade, migration and now the digital age. Throughout these transitions, there has been a progressive population explosion and net ecosystem loss and degradation. Climate change now gathers pace, exacerbated by ecological dysfunction. Our health status has been challenged by a developing people-environment mismatch. We have regarded ecological conquest and innovative technology as solutions, but have not understood how ecologically dependent and integrated we are...
December 2016: Asia Pacific Journal of Clinical Nutrition
Yvonne Ten Hoeve, Stynke Castelein, Wiebren S Jansen, Gerard J Jansen, Petrie F Roodbol
BACKGROUND: Previous studies have shown that nursing students' perceptions of nursing change over time. Little research has been undertaken in the Netherlands of students entering nursing programmes and of how they progress. OBJECTIVES: The aims of this study were to explore whether nursing students' orientation and attitudes towards nursing changed over time, when these changes occurred, and what factors influenced the changes. We also aimed to identify the factors which prompted them to consider leaving their programmes, and what factors affected their motivation to stay...
September 26, 2016: Nurse Education Today
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