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Residents' clinic

Michelle M Valdez, Maureen Liwanag, Charles Mount, Rechell Rodriguez, Elisea Avalos-Reyes, Andrew Smith, David Collette, Michael Starsiak, Richard Green
Introduction: Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project...
March 14, 2018: Military Medicine
Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
Hesham Mostafa Zakaria, Peter Joseph Massa, Richard L Smith, Tarek Hazem Moharram, John Corrigan, Ian Lee, Lonni Schultz, Jianhui Hu, Suresh Patel, Brent Griffith
Preoperative identification of the eloquent brain is important for neurosurgical planning. One common method of finding the motor cortex is by localizing "the Omega sign." No studies have tested the reliability of imaging to identify the Omega sign. We identified 40 recent and consecutive patients who had undergone preoperative functional magnetic resonance imaging for identification of the hand motor area prior to tumor resection. We recruited 11 neurosurgical residents of various levels of training and one board-certified neurosurgeon to identify the hand motor cortex Omega...
January 1, 2018: Neuroradiology Journal
Maya Balakrishnan, Rollin George, Ashish Sharma, David Y Graham, Hoda M Malaty
BACKGROUND: The USA has among the lowest gastric cancer incidence rates worldwide. AIM: To investigate whether increasing immigration from high cancer incidence countries has altered the GC incidence in a large US metropolitan area. METHODS: This was a retrospective cohort study among an underprivileged, multiethnic population in Texas. Gastric cancer cases diagnosed during 2005-2015 were identified using the cancer registry of the public medical care system for Harris County...
March 15, 2018: Digestive Diseases and Sciences
Robin R van Tol, Marieke P A Bruijnen, Jarno Melenhorst, Sander M J van Kuijk, Laurents P S Stassen, Stéphanie O Breukink
PURPOSE: In this study, we describe current practices in the management of hemorrhoidal disease in the Netherlands. METHODS: A validated online survey was performed among Dutch surgeons and residents treating hemorrhoidal disease. Contact details were retrieved from the Dutch Association for Surgery resulting in 619 contacts. Only doctors who were treating hemorrhoidal disease regularly were asked to complete the questionnaire. The following items were assessed: initial treatment, recurrence, complications, and follow-up...
March 15, 2018: International Journal of Colorectal Disease
Chew Lip Ng, Xuan Dao Liu, Renuka Murali Govind, Jonathan Wei Jian Tan, Shirley Beng Suat Ooi, Sophia Archuleta
INTRODUCTION: Postgraduate medical education in Singapore underwent major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of residency sponsoring institutions (SIs) among medical students during this transition period. METHODS: A questionnaire-based cross-sectional study of Singaporean undergraduate medical students across all years of study was performed in 2011...
March 16, 2018: Singapore Medical Journal
Joshua W Joseph, Samuel Davis, Elissa H Wilker, Matthew L Wong, Ori Litvak, Stephen J Traub, Larry A Nathanson, Leon D Sanchez
OBJECTIVES: Emergency physician productivity, often defined as new patients evaluated per hour, is essential to planning clinical operations. Prior research in this area considered this a static quantity; however, our group's study of resident physicians demonstrated significant decreases in hourly productivity throughout shifts. We now examine attending physicians' productivity to determine if it is also dynamic. METHODS: This is a retrospective cohort study, conducted from 2014 to 2016 across three community hospitals in the north-eastern USA, with different schedules and coverage...
March 15, 2018: Emergency Medicine Journal: EMJ
Sarah Edgerley, Conor McKaigney, Devon Boyne, Darrell Ginsberg, Jeffrey Damon Dagnone, Andrew Koch Hall
AIM: Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. METHODS: This retrospective cohort study enrolled EM residents at a single Canadian academic centre over a six-year period. Residents completed twice-annual simulation-based resuscitation-focused objective structured clinical examinations (OSCEs) with assessment in four domains (primary assessment, diagnostic actions, therapeutic actions and communication), and a global assessment score (GAS)...
March 12, 2018: Resuscitation
M Austin Coker, Carrie E Huisingh, Gerald McGwin, Russell W Read, Mark W Swanson, Laura E Dreer, Dawn K DeCarlo, Lindsay Gregg, Cynthia Owsley
Importance: The prevalence of irreversible vision impairment in the United States is expected to increase by 2050. Vision rehabilitation is the primary treatment option. Clinical trials have established its efficacy in improving quality of life. Yet studies indicate that patients experience many barriers to accessing low-vision care. Objectives: To examine the rate of referral for low-vision rehabilitation services by resident and attending ophthalmologists for adults with irreversible vision impairment and to assess the knowledge, attitudes, and beliefs of patients about vision rehabilitation...
March 15, 2018: JAMA Ophthalmology
Marcia C Inhorn, Pasquale Patrizio
Reproductive health services, including infertility care, are important in countries with infrastructure deficits, such as Lebanon, which now hosts more than one million Syrian refugees. Islamic prohibitions on child adoption and third-party reproductive assistance (donor eggs, sperm, embryos, and surrogacy) mean that most Muslim couples must turn to in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) to overcome their childlessness. Attempts to bring low-cost IVF-ICSI to underserved populations might help infertile couples where no other services are available...
March 1, 2018: AMA Journal of Ethics
Olivia Farrer, Alison Yaxley, Karen Walton, Michelle Miller
AIM: The prevalence of diabetes in older adults in residential aged care (RAC) is twice that of community dwelling older adults. Older adults with diabetes have been highlighted as being at high risk of frailty and malnutrition, particularly when managed on a therapeutic diet. However, assumptions may be based on clinical presentation of our oldest old which may be at conflict with the clinical presentation of younger older adults. The aim of this retrospective audit was to identify the characteristics of aged care residents with diabetes, their comorbidities and malnutrition risk...
March 15, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
F Sancassiani, Mauro G Carta, Roberta Montisci, Antonio Preti, Sergio Machado, Maria F Moro, Maria F Marchetti, Luigi Meloni
Background: The aim was to study the association between mood and anxiety disorders and the Tako-Tsubo Syndrome (TTS) and to determine the role of antidepressants and the impairment of quality of life due the comorbid psychiatric disorder. Methods: Case-control study: 19 consecutive patients (17 female) with TTS compared to 76 controls without TTS, were randomly selected from the database of a nationwide epidemiological study after matching (gender, age and residence) by controls...
2018: Clinical Practice and Epidemiology in Mental Health: CP & EMH
Xinhua Yu, Anika Kasprick, Karin Hartmann, Frank Petersen
Skin mast cells (MCs), a resident immune cell type with broad regulatory capacity, play an important role in sensing danger signals as well as in the control of the local immune response. It is conceivable to expect that skin MCs regulate autoimmune response and are thus involved in autoimmune diseases in the skin, e.g., autoimmune bullous dermatoses (AIBD). Therefore, exploring the role of MCs in AIBD will improve our understanding of the disease pathogenesis and the search for novel therapeutic targets. Previously, in clinical studies with AIBD, particularly bullous pemphigoid, patients' samples have demonstrated that MCs are likely involved in the development of the diseases...
2018: Frontiers in Immunology
Attia Bari, Rehan Ahmed Khan, Ahsan Waheed Rathore
OBJECTIVE: To evaluate the perception of postgraduate residents about the clinical educational environment and to investigate the association of their perception with different specialities and years of residency. METHODS: The study was conducted in August 2016 at The Children's Hospital, Lahore, Pakistan, and comprised postgraduate residents who were asked to complete postgraduate hospital educational environment measure questionnaire. The residents' individual perception scores were calculated and the means of both individual domain and global score of the questionnaire were compared by different specialities and different levels of residency training year...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Cynthia M Rand, Stanley J Schaffer, Nui Dhepyasuwan, Aaron Blumkin, Christina Albertin, Janet R Serwint, Paul M Darden, Sharon G Humiston, Keith J Mann, William Stratbucker, Peter G Szilagyi
BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. METHODS: Staff and providers in 8 resident clinics participated in a 12-month QI study...
March 14, 2018: Pediatrics
James Rourke, Danielle O'Keefe, Mohamed Ravalia, Scott Moffatt, Wanda Parsons, Norah Duggan, Katherine Stringer, Michael Jong, Kristin Harris Walsh, Janelle Hippe
OBJECTIVE: To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. DESIGN: Analysis of anonymized secondary data. SETTING: Canada. PARTICIPANTS: Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091)...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Eva Purkey, Rupa Patel, Tracey Beckett, Françoise Mathieu
OBJECTIVE: To understand the primary care experiences of women who have a history of childhood trauma and chronic disease. DESIGN: Qualitative study using in-depth interviews with directed content analysis. SETTING: Family health team in Kingston, Ont. PARTICIPANTS: Twenty-six women. METHODS: Letters of invitation were sent to eligible participants followed by a telephone survey. Women with an adverse childhood experience (ACE) score of 4 or higher and with 2 or more chronic conditions were invited to participate in a one-on-one interview...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Lindsey Realmuto, Alexandra Kamler, Linda Weiss, Tiffany L Gary-Webb, Michael E Hodge, José A Pagán, Elizabeth A Walker
The National Diabetes Prevention Program (NDPP) has been effectively translated to various community and clinical settings; however, regardless of setting, enrollment among men and lower-income populations is low. This study presents participant perspectives on Power Up for Health, a novel NDPP pilot adaption for men residing in low-income communities in New York City. We conducted nine interviews and one focus group with seven participants after the program ended. Interview and focus group participants had positive perceptions of the program and described the all-male aspect of the program and its reliance on male coaches as major strengths...
March 1, 2018: American Journal of Men's Health
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