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https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#1
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441660/the-phenotype-and-outcome-of-infantile-cardiomyopathy-caused-by-a-homozygous-elac2-mutation
#2
Zarghuna M A Shinwari, Abdulrahman Almesned, Ali Alakhfash, Ahmad M Al-Rashdan, Eissa Faqeih, Zainab Al-Humaidi, Ahmed Alomrani, Malak Alghamdi, Dilek Colak, Abdullah Alwadai, Monther Rababh, Majid Al-Fayyadh, Zuhair N Al-Hassnan
OBJECTIVE: Cardiomyopathy (CMP) in children is a clinically and genetically heterogeneous group of disorders. Disease-associated mutations have been identified in more than 50 genes. Recently, mutations in the mitochondrial tRNA processing gene, ELAC2, were reported to be associated with the recessively inherited form of hypertrophic CMP (HCM). This study is aimed at describing the cardiac phenotype and outcome of ELAC2 mutation. METHODS: We performed whole exome sequencing followed by targeted mutation screening to identify the genetic etiology of severe infantile-onset CMP in 64 consanguineous Saudi families...
April 26, 2017: Cardiology
https://www.readbyqxmd.com/read/28441300/speech-detection-in-noise-for-young-bilaterally-implanted-children-is-there-evidence-of-binaural-benefit-over-the-shadowed-ear-alone
#3
Karyn L Galvin, Richard C Dowell, Richard J van Hoesel, Mansze Mok
OBJECTIVES: To measure binaural benefit over the shadowed ear alone for young bilateral cochlear implant (CI) users. It was hypothesized that children who received bilateral CIs at a young age (<4 years), and had significant bilateral experience, would demonstrate lower detection thresholds for speech sounds in background noise in the bilateral CI over the unilateral CI condition when the added CI was ipsilateral to the noise source. DESIGN: Children receiving bilateral CIs at the Eye and Ear Hospital Clinic in Melbourne were invited to participate in a wider research project evaluating outcomes; those participating in the wider project who were bilaterally implanted by 4 years and were approximately 2 years postoperative were included in the present study...
April 22, 2017: Ear and Hearing
https://www.readbyqxmd.com/read/28441169/psychosocial-interventions-in-stimulant-use-disorders-a-focus-on-women
#4
Riccardo De Giorgi, Gian L D'Alò, Franco De Crescenzo
PURPOSE OF REVIEW: Stimulant use disorders are significant contributors to the global burden of disease, with a growing impact on women. Psychosocial interventions are the gold standard for treating this condition, but several barriers may prevent women from accessing appropriate treatment. Therefore, we systematically reviewed the most recent findings about psychosocial interventions for stimulant use disorders, focussing on results relevant to women. RECENT FINDINGS: Twenty-two eligible studies were identified...
April 22, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28441128/early-career-work-location-of-memorial-university-medical-graduates-why-the-decline-in-rural-practice
#5
Maria Mathews, Dana Ryan, Asoka Samarasena
INTRODUCTION: In a previous study, we found a decline in the proportion of Memorial University of Newfoundland (MUN) medical alumni practising in rural areas, particularly in Newfoundland and Labrador. The current study focused on the work location of recent graduates and examined the predictors of working in rural Canada and in rural Newfoundland and Labrador within the first 15 years following graduation. METHODS: We linked data from graduating class lists and the alumni and postgraduate databases with Scott's Medical Database to create a record of all graduates from 1973 to 2008, including their work location...
2017: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/28441119/comparable-efficacy-of-behavioral-and-pharmacological-treatments-among-african-american-and-white-cocaine-users
#6
LaTrice Montgomery, Kathleen M Carroll
Multiple randomized clinical trials (RCTs) have evaluated a range of treatments for cocaine dependence, but few of these have focused specifically on the racial diversity observed among cocaine-dependent patients. The present analyses evaluated racial variation in cocaine use and addiction-related psychosocial outcomes at baseline and follow-up among 388 African American and White adults participating in 1 of 5 RCTs evaluating a range of pharmacological and behavioral treatments for cocaine use disorders. General linear modeling (GLM) indicated significant racial variation in cocaine and psychosocial indicators at baseline...
April 25, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/28440861/findings-from-the-families-on-track-intervention-pilot-trial-for-children-with-fetal-alcohol-spectrum-disorders-and-their-families
#7
Christie L M Petrenko, Mary E Pandolfino, Luther K Robinson
BACKGROUND: Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multi-component intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. METHODS: Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled...
April 25, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28440674/late-talkers-and-later-language-outcomes-predicting-the-different-language-trajectories
#8
Rebecca Armstrong, James G Scott, Andrew J O Whitehouse, David A Copland, Katie L Mcmahon, Wendy Arnott
PURPOSE: The aim of the current study was to investigate the risk factors present at 2 years for children who showed language difficulties that persisted from 2 to 10 years and difficulties that emerged later, at 10 years. METHOD: Participants (n = 783) were drawn from the Raine Study in Western Australia. Patterns of change from 2 to 10 years were identified based on child performance on the Language Development Survey and the Clinical Evaluation of Language Fundamentals, respectively...
April 25, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28440334/trends-in-perinatal-mortality-and-its-risk-factors-in-japan-analysis-of-vital-registration-data-1979-2010
#9
Maaya Kita Sugai, Stuart Gilmour, Erika Ota, Kenji Shibuya
As Japan has achieved one of the lowest perinatal mortality rates (PMR), our study aims to estimate trends in and risk factors for perinatal mortality among singleton births in Japan. We used Japanese vital registration data to assess trends in and risk factors for perinatal outcomes between 1979 and 2010. Birth and death registration data were merged. An autoregressive integrated moving average model was fitted separately by sex to the PMR and the proportion of stillbirths. A multilevel Poisson regression model was used to estimate risk factors for perinatal mortality...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28440111/quality-of-life-outcomes-in-a-pediatric-thalassemia-population-in-egypt
#10
Soheir Adam, Hanan Afifi, Manal Thomas, Phoebe Magdy, Ghada El-Kamah
Thalassemia is a disorder of hemoglobin (Hb) synthesis characterized by chronic hemolysis. In β-thalassemias major (β-TM), patients require regular transfusion at an early age due to severe anemia. Subsequently, intensive chelation therapy is initiated to mitigate the effects of the resultant iron overload. Clinical disease burden and the demanding treatment can affect health-related quality of life (HRQoL) outcomes in this population. The aim of this study was to assess HRQoL outcomes in Egyptian pediatric thalassemia patients...
April 25, 2017: Hemoglobin
https://www.readbyqxmd.com/read/28439752/mathematical-modeling-of-cellular-cross-talk-between-endothelial-and-tumor-cells-highlights-counterintuitive-effects-of-vegf-targeted-therapies
#11
Harsh Jain, Trachette Jackson
Tumor growth and progression are critically dependent on the establishment of a vascular support system. This is often accomplished via the expression of pro-angiogenic growth factors, including members of the vascular endothelial growth factor (VEGF) family of ligands. VEGF ligands are overexpressed in a wide variety of solid tumors and therefore have inspired optimism that inhibition of the different axes of the VEGF pathway-alone or in combination-would represent powerful anti-angiogenic therapies for most cancer types...
April 24, 2017: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/28439622/long-term-impacts-of-parental-migration-on-chinese-children-s-psychosocial-well-being-mitigating-and-exacerbating-factors
#12
Chenyue Zhao, Feng Wang, Leah Li, Xudong Zhou, Therese Hesketh
PURPOSE: Prolonged separation from migrant parents raises concerns for the well-being of 60 million left behind children (LBC) in rural China. This study aimed to investigate the impact of current and previous parental migration on child psychosocial well-being, with a focus on emotional and behavioral outcomes, while considering factors in family care and support. METHODS: Children were recruited from schools in migrant-sending rural areas in Zhejiang and Guizhou provinces by random stratified sampling...
April 24, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28439532/recruiting-to-preclinical-alzheimer-s-disease-clinical-trials-through-registries
#13
Joshua D Grill
Participant registries are repositories of individuals who have expressed willingness to learn about studies for which they may be eligible. Registries are increasingly being utilized to improve recruitment to preclinical Alzheimer's disease (AD) clinical trials, which require large screening efforts to identify adequate numbers of participants who meet enrollment criteria. Recruiting to preclinical AD trials from registries is made more efficient through registry collection of data that permits exclusion of those who will not be eligible and identifies individuals most likely to qualify for trials...
June 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/28438320/critical-care-nurses-perceptions-of-the-outcomes-of-working-overtime-in-canada
#14
Vanessa M Lobo, Jenny Ploeg, Anita Fisher, Gladys Peachey, Noori Akhtar-Danesh
BACKGROUND: Nursing overtime is being integrated into the normal landscape of practice to ensure optimal staffing levels and addresses variations in patient volume and acuity. This is particularly true in critical care where fluctuations in either are difficult to predict. PURPOSE: The goal of this study was to explore critical care nurses' perceptions of the outcomes of working overtime. METHODS: Sally Thorne's interpretive description guided the collection and analysis of data...
January 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#15
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437219/factors-affecting-sexual-function-in-midlife-women-results-from-the-midlife-women-s-health-study
#16
Rebecca L Smith, Lisa Gallicchio, Jodi A Flaws
OBJECTIVE: The objective of this study was to estimate the importance of risk factors affecting sexual function in sexually active midlife women. MATERIALS AND METHODS: A cohort of 780 women undergoing the menopausal transition was surveyed each year for up to 7 years. Data were collected from sexually active women on sexual function, including frequencies of enjoyment, arousal, orgasm, passion for partner, satisfaction with partner, pain, lack of lubrication, fantasizing, and sexual activity...
February 28, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#17
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
February 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437059/psychotic-and-bipolar-disorders-bipolar-disorder
#18
Sarah D Holder
Bipolar disorder is a severe chronic mental illness that affects a large number of individuals. This disorder is separated into two major types, bipolar I disorder, with mania and typically recurrent depression, and bipolar II disorder, with recurrent major depression and hypomania. Patients with bipolar disorder spend the majority of time experiencing depression, and this typically is the presenting symptom. Because outcomes are improved with earlier diagnosis and treatment, physicians should maintain a high index of suspicion for bipolar disorder...
April 2017: FP Essentials
https://www.readbyqxmd.com/read/28436587/coparenting-conflict-and-academic-readiness-in-children-of-teen-mothers-effortful-control-as-a-mediator
#19
Laudan B Jahromi, Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umaña-Taylor, Sara Douglass Bayless
Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican-origin adolescent mothers' coparenting conflict with their 3-year-old children's grandmothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness...
April 24, 2017: Family Process
https://www.readbyqxmd.com/read/28436286/coordinated-asthma-program-improves-asthma-outcomes-in-high-risk-children
#20
Faye Holder-Niles, Linda Haynes, Helen D'Couto, Rebecca S Hehn, Dionne A Graham, Ann Chen Wu, Joanne E Cox
Innovative approaches within primary care are needed to reduce fragmented care, increase continuity of care, and improve asthma outcomes in children with asthma. Our objective was to assess the impact of coordinated team-based asthma care on unplanned asthma-related health care utilization. A multidisciplinary asthma team was developed to provide coordinated care to high-risk asthma patients. Patients received an in-depth diagnostic and family needs assessment, asthma education, and coordinated referral to social and community services...
April 1, 2017: Clinical Pediatrics
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