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Medical problem solving

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https://www.readbyqxmd.com/read/27921218/from-problem-solving-to-problem-definition-scrutinizing-the-complex-nature-of-clinical-practice
#1
Sayra Cristancho, Lorelei Lingard, Glenn Regehr
In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations...
December 5, 2016: Perspectives on Medical Education
https://www.readbyqxmd.com/read/27920270/think-like-a-hacker-insights-on-the-latest-attack-vectors-and-security-controls-for-medical-device-applications
#2
Mandeep Khera
Ready or not, the Internet of things (IoT) is here. No longer just a buzz term, it'll continue to grow at an unprecedented pace over the next few years expecting to reach over 25 billion connected devices by 2020. History shows us that most fast growth technology solutions focus on solving business problems first and security is an afterthought. Unfortunately, IoT is following the same trend. Most IoT devices, apps, and infrastructure were developed without security in mind and are likely going to become targets of hackers...
December 4, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27917517/student-evaluation-team-focus-groups-increase-students-satisfaction-with-the-overall-course-evaluation-process
#3
Katharina Brandl, Jess Mandel, Babbi Winegarden
CONTEXT: Most medical schools use online systems to gather student feedback on the quality of their educational programmes and services. Online data may be limiting, however, as the course directors cannot question the students about written comments, nor can students engage in mutual problem-solving dialogue with course directors. We describe the implementation of a student evaluation team (SET) process to permit course directors and students to gather shortly after courses end to engage in feedback and problem solving regarding the course and course elements...
December 5, 2016: Medical Education
https://www.readbyqxmd.com/read/27911677/managing-chronic-conditions-in-college-findings-from-prompted-health-incidents-diaries
#4
Russell D Ravert, Luke T Russell, Monica B O'Guin
OBJECTIVE: This pilot study assessed an electronic health diary method designed to collect data about critical health incidents experienced by college students who have chronic health conditions. PARTICIPANTS: Nine university students with chronic medical conditions were recruited to complete a series of email-based surveys, sent once every three days across the fall 2014 semester. METHODS: In each survey, participants described a health-related incident that occurred within the past day and cite resources that helped or could have helped in that situation...
December 2, 2016: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/27911004/a-comparison-of-the-neuropsychological-profiles-of-people-living-in-squalor-without-hoarding-to-those-living-in-squalor-associated-with-hoarding
#5
Sook Meng Lee, Matthew Lewis, Deborah Leighton, Ben Harris, Brian Long, Stephen Macfarlane
OBJECTIVE: Squalor affects 1 in 1000 older people and is regarded as a secondary condition to other primary disorders such as dementia, intellectual impairment and alcohol abuse. Squalor frequently is associated with hoarding behaviour. We compared the neuropsychological profile of people living in squalor associated with hoarding to those presenting with squalor only. METHODS: This study is a retrospective case series of hospital inpatient and community healthcare services of 69 people living in squalor (49 from aged care, 16 from aged psychiatry, 3 from acute medical and 1 from a memory clinic)...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27910417/new-numerical-simulation-method-to-calibrate-the-regular-hexagonal-nai-tl-detector-with-radioactive-point-sources-situated-non-axial
#6
Ayman Hamzawy, Dimitar N Grozdanov, Mohamed S Badawi, Fuad A Aliyev, Abouzeid A Thabet, Mahmoud I Abbas, Ivan N Ruskov, Ahmed M El-Khatib, Yuri N Kopatch, Mona M Gouda
Scintillation crystals are usually used for detection of energetic photons at room temperature in high energy and nuclear physics research, non-destructive analysis of materials testing, safeguards, nuclear treaty verification, geological exploration, and medical imaging. Therefore, new designs and construction of radioactive beam facilities are coming on-line with these science brunches. A good number of researchers are investigating the efficiency of the γ-ray detectors to improve the models and techniques used in order to deal with the most pressing problems in physics research today...
November 2016: Review of Scientific Instruments
https://www.readbyqxmd.com/read/27904214/results-of-neurolysis-in-established-upper-limb-volkmann-s-ischemic-contracture
#7
Dinesh K Meena, Srikiran Thalanki, Poornima Patni, Ram Khiladi Meena, Dinesh Bairawa, Chirag Bhatia
BACKGROUND: Treatment of established cases of Volkmann's ischemic contracture (VIC) of upper limb is very tedious. Since the period of Volkmann, various experimental works are being performed for its treatment, but none are effective. Disabilities from nerve palsy and hand muscle paralysis are more problematic than any other deformity in VIC. To solve these problems, we conducted a study to see the result of neurolysis of median and ulnar nerve and their subcutaneous placement in established cases of VIC...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27894227/multidisciplinary-teams-involved-detection-of-drug-related-problems-through-continuity-of-care
#8
Elena Yaiza Romero-Ventosa, Marisol Samartín-Ucha, Alicia Martín-Vila, María Lucía Martínez-Sánchez, Isabel Rey Gómez-Serranillos, Guadalupe Pineiro-Corrales
OBJECTIVE: To quantify Drug-Related problems (DRPs) by establishing a Strategic Continuity of Care Program (e-Conecta- Concilia Program; e-CC) focused on the drug therapy of patients within an Integrated Management Structure, in order to guarantee the therapeutical efficiency, safety and traceability of patients. METHOD: A prospective study at 8 months. The project included 22 Hospital Pharmacists and 12 Primary Care Pharmacists. Electronic clinical records were used, which can be accessed by all healthcare levels...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27884182/operations-research-for-resource-planning-and-use-in-radiotherapy-a-literature-review
#9
Bruno Vieira, Erwin W Hans, Corine van Vliet-Vroegindeweij, Jeroen van de Kamer, Wim van Harten
BACKGROUND: The delivery of radiotherapy (RT) involves the use of rather expensive resources and multi-disciplinary staff. As the number of cancer patients receiving RT increases, timely delivery becomes increasingly difficult due to the complexities related to, among others, variable patient inflow, complex patient routing, and the joint planning of multiple resources. Operations research (OR) methods have been successfully applied to solve many logistics problems through the development of advanced analytical models for improved decision making...
November 25, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27881121/knowledge-is-not-enough-to-solve-the-problems-the-role-of-diagnostic-knowledge-in-clinical-reasoning-activities
#10
Jan Kiesewetter, Rene Ebersbach, Nike Tsalas, Matthias Holzer, Ralf Schmidmaier, Martin R Fischer
BACKGROUND: Clinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown. METHODS: Medical students (n = 21) were exposed to three different clinical cases and instructed to use the think-aloud method...
November 24, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27880073/an-interprofessional-health-assessment-program-in-rural-amateur-sport
#11
Sandra Grace, Rosanne Coutts
Effective interprofessional learning (IPL) in multisectoral collaborations such as those linking health services within communities can provide an authentic experience for students and also appears to be the most effective way to achieve health changes in targeted population groups. The aim of this study was to facilitate the IPL of students at a rural university in a multisectoral health assessment programme and to promote health in players of rural amateur sport. Two rural rugby league teams took part in three pre-season health assessments conducted by general medical practitioners, practice nurses, and nursing, osteopathy, and exercise science students...
November 23, 2016: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27871183/hiv-patient-and-provider-feedback-on-a-telehealth-collaborative-care-for-depression-intervention
#12
Karen L Drummond, Jacob T Painter, Geoffrey M Curran, Regina Stanley, Allen L Gifford, Maria Rodriguez-Barradas, David Rimland, Thomas P Monson, Jeffrey M Pyne
In the HIV Translating Initiatives for Depression into Effective Solutions project, we conducted a randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care in Veterans Health Administration HIV clinics in the US. An offsite HIV depression care team including a psychiatrist, a depression care manager (DCM), and a clinical pharmacist provided collaborative care using a stepped-care model of treatment and made recommendations to providers through the electronic health record system...
November 22, 2016: AIDS Care
https://www.readbyqxmd.com/read/27865742/internal-rectal-prolapse-definition-assessment-and-management-in-2016
#13
L Cariou de Vergie, A Venara, E Duchalais, E Frampas, P A Lehur
Internal rectal prolapse (IRP) is a well-recognized pelvic floor disorder mainly seen during defecatory straining. The symptomatic expression of IRP is complex, encompassing fecal continence (56%) and/or evacuation disorders (85%). IRP cannot be characterized easily by clinical examination alone and the emergence of dynamic defecography (especially MRI) has allowed a better comprehension of its pathophysiology and led to the proposition of a severity score (Oxford score) that can guide management. Decision for surgical management should be multidisciplinary, discussed after a complete work-up, and only after medical treatment has failed...
November 16, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27864251/post-hoc-evaluation-of-a-common-sense-intervention-for-asthma-management-in-community-pharmacy
#14
Kim Watkins, Liza Seubert, Carl R Schneider, Rhonda Clifford
OBJECTIVES: The aim was to evaluate a common-sense, behavioural change intervention to implement clinical guidelines for asthma management in the community pharmacy setting. DESIGN: The components of the common-sense intervention were described in terms of categories and dimensions using the Intervention Taxonomy (ITAX) and Behaviour Change Techniques (BCTs) using the Behaviour Change Wheel (BCW), Capability, Opportunity and Motivation-Behaviour (COM-B) System and Behaviour Change Techniques Taxonomy (BCTTv1)...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27857845/an-improved-teaching-learning-based-robust-edge-detection-algorithm-for-noisy-images
#15
Sasirooba Thirumavalavan, Sasikala Jayaraman
This paper presents an improved Teaching Learning Based Optimization (TLO) and a methodology for obtaining the edge maps of the noisy real life digital images. TLO is a population based algorithm that simulates the teaching-learning mechanism in class rooms, comprising two phases of teaching and learning. The 'Teaching Phase' represents learning from the teacher and 'Learning Phase' indicates learning by the interaction between learners. This paper introduces a third phase denoted by "Avoiding Phase" that helps to keep the learners away from the worst students with a view of exploring the problem space more effectively and escaping from the sub-optimal solutions...
November 2016: Journal of Advanced Research
https://www.readbyqxmd.com/read/27857421/markov-chain-solution-of-photon-multiple-scattering-through-turbid-slabs
#16
Ying Lin, William F Northrop, Xuesong Li
This work introduces a Markov Chain solution to model photon multiple scattering through turbid slabs via anisotropic scattering process, i.e., Mie scattering. Results show that the proposed Markov Chain model agree with commonly used Monte Carlo simulation for various mediums such as medium with non-uniform phase functions and absorbing medium. The proposed Markov Chain solution method successfully converts the complex multiple scattering problem with practical phase functions into a matrix form and solves transmitted/reflected photon angular distributions by matrix multiplications...
November 14, 2016: Optics Express
https://www.readbyqxmd.com/read/27856672/executive-functioning-in-children-and-adolescents-with-perinatal-hiv-infection-and-perinatal-hiv-exposure
#17
Sharon L Nichols, Miriam C Chernoff, Kathleen M Malee, Patricia A Sirois, Steven P Woods, Paige L Williams, Cenk Yildirim, Dean Delis, Betsy Kammerer
BACKGROUND: Executive functions (EFs) are critical for management of life activities, but few studies have evaluated EFs in children and adolescents with perinatally acquired HIV (PHIV), who are at risk for problems in academics, behavior, and medication adherence. We compared EFs in youth with PHIV and in perinatally HIV-exposed but uninfected (PHEU) youth. METHODS: Four Delis-Kaplan Executive Function System (D-KEFS) subtests were administered to 173 youth with PHIV and 85 PHEU youth, aged 9 to <19 years, who were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Memory and Executive Functioning Study...
December 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27853359/age-related-hearing-loss-in-individuals-and-their-caregivers-effects-of-coping-on-the-quality-of-life-among-the-dyads
#18
Sébastien Lazzarotto, Karine Baumstarck, Anderson Loundou, Zeinab Hamidou, Valérie Aghababian, Tanguy Leroy, Pascal Auquier
OBJECTIVES: Age-related hearing loss (ARHL) impacts the daily living and quality of life (QoL) of affected individuals and the functioning of family caregivers. In the specific context of voluntary medical checkups, we examined sample dyads (ARHL individual and the caregiver) to determine whether QoL of patients and caregivers is influenced by coping strategies implemented either by themselves or their relatives. METHODS: This was a cross-sectional study with a descriptive/correlative design performed in a French preventive health center (Regional Institute for Prevention of Aging, Marseille, France) for the beneficiaries of pension funds of private sector employees...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27852144/appreciative-inquiry-in-medical-education
#19
John Sandars, Deborah Murdoch-Eaton
The practice of medicine, and also medical education, typically adopts a problem-solving approach to identify "what is going wrong" with a situation. However, an alternative is Appreciative Inquiry (AI), which adopts a positive and strengths-based approach to identify "what is going well" with a situation. The AI approach can be used for the development and enhancement of the potential of both individuals and organizations. An essential aspect of the AI approach is the generative process, in which a new situation is envisioned and both individual and collective strengths are mobilized to make changes to achieve the valued future situation...
November 17, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27835799/a-nursing-perspective-of-interprofessional-work-in-critical-care-findings-from-a-secondary-analysis
#20
Deborah Kendall-Gallagher, Scott Reeves, Janet A Alexanian, Simon Kitto
PURPOSE: This article presents a secondary analysis of nurse interviews from a 2-year comparative ethnographic study exploring cultures of collaboration across intensive care units (ICU). Critically ill patients rely on their interprofessional health care team to communicate and problem-solve quickly to give patients the best outcome available. Critical care nurses function at the hub of patient care giving them a distinct perspective of how interprofessional interactions impact collaborative practice...
October 19, 2016: Journal of Critical Care
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