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Ambulatory education

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https://www.readbyqxmd.com/read/28992891/patterns-of-medical-utilization-before-the-first-hospitalization-for-women-with-anorexia-nervosa-in-taiwan
#1
Yen-Ni Hung, Chian-Jue Kuo, Shu-Yu Yang, Ming-Chyi Huang, Ying-Yeh Chen, Shih-Ku Lin, Kuan-Yu Chen
OBJECTIVE: The aim of this paper was to analyze medical utilization patterns of female patients with anorexia nervosa before their first inpatient care visit for anorexia nervosa using the National Health Insurance Research Database (NHIRD) of Taiwan. METHOD: We selected female anorexia nervosa patients (n=239) and control participants hospitalized for peptic ulcers (n=478) or appendectomy (n=478) who were matched by age and incident year from two subsets of the NHIRD...
November 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28991845/a-purpose-driven-fourth-year-of-medical-school
#2
Mantosh Dewan, John Norcini
The fourth year of medical school has been repeatedly found to be ineffective, and concerns exist about its purpose and academic quality, as well as grade inflation. Since Flexner, the purpose of undergraduate medical training has moved from readiness for independent practice to readiness for postgraduate training. However, training directors report that medical graduates are inadequately prepared to enter residency. The authors propose a fourth year with two components: first, a yearlong, longitudinal ambulatory experience of at least three days each week on an interprofessional team with consistent faculty supervision and mentoring, increasing independence, and a focus on education; and second, rigorous clinical-scales-based assessment of meaningful outcomes...
October 3, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28988689/residency-pathways-to-ambulatory-care-practice-essential-insights-for-students-residents-and-educators
#3
Sarah M Westberg, Stuart J Beatty, Andrea R Corona, Sarah Deines, Karen M Gunning, Holly E Gurgle, Haley S Holtan, Macary Weck Marciniak, Karen J McConnell, Melissa A Somma McGivney, Rachana J Patel
OBJECTIVE: To provide a guiding document describing residency training opportunities in ambulatory care for students, postgraduate year 1 (PGY1) residents, practicing pharmacists, and pharmacy educators. SUMMARY: Student pharmacists, residents, practitioners, and educators can benefit from a guiding document describing the various pathways to develop as an ambulatory care practitioner through residency training. The benefits and differences of PGY1 and postgraduate year 2 (PGY2) ambulatory care residency programs are included...
October 5, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28970040/-the-private-pediatrician-in-the-clinical-care-pathway-for-children-affected-by-specific-learning-disorders-in-france
#4
T-N Willig, J P Blanc, R Assathiany
The clinical care pathway for children presenting specific learning disorders, including language, motor coordination, and attention disorders is based on different levels of assessment by the professionals involved. In France, a first step of organization was established in 2002 by founding of a network of structures devoted to clinical assessment of complex cases, research, and teaching for the professionals involved. Although this organization proved to contribute an essential service, the demand largely exceeded the availability of access...
September 29, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28967953/ensuring-the-quality-of-point-of-care-testing-in-a-large-and-decentralized-ambulatory-care-setting
#5
Valerie A Arboleda, Omai B Garner
Objectives: In this project, we assessed the breadth, quality, trends, and outcomes of point-of-care (POC) testing and regulatory compliance in 200 University of California, Los Angeles (UCLA) Health system outpatient clinics. Methods: We retrospectively extracted clinic POC test orders, results, and e-prescription data from the UCLA electronic health record over a 1-year period. Results: Over 100,000 total tests were performed, encompassing 10 POC tests...
October 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28957879/perioperative-management-of-cardiac-rhythm-assist-devices-in-ambulatory-surgery-and-nonoperating-room-anesthesia
#6
Lovkesh Arora, Chakradhari Inampudi
PURPOSE OF REVIEW: Patients with cardiac implantable electronic devices (CIEDs) frequently undergo various surgical procedures and in the past perioperative management involved only placing magnet over the device. New programming features, development of implantable cardiac defibrillator (ICD), cardiac resynchronization therapy, and increasing complexity of the operating room equipment have led to new sources of electromagnetic interference (EMI). A comprehensive understanding of the CIED is necessary to provide a timely and optimal care to the patients...
September 27, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28953296/effective-learning-in-an-ambulatory-family-medicine-clerkship-a-qualitative-study-of-medical-student-midpoint-feedback
#7
Melissa K Bradner, Sharon Kaufer Flores, Judy S Gary, Sharon Zumbrunn
BACKGROUND AND OBJECTIVES: There is substantial research on the effectiveness of ambulatory medical preceptors' teaching skills, but less is known about the student perspective on what contributes most to effective learning in a busy clinical practice. METHODS: As part of a formative midpoint assessment during the third-year clerkship in family medicine, students were asked to respond to the following open-ended reflective prompt: "My preceptor contributed to my learning by...
September 2017: Family Medicine
https://www.readbyqxmd.com/read/28940503/measuring-arterial-blood-pressure-in-humans-auscultatory-and-automatic-measurement-techniques-for-human-biological-field-studies
#8
Gary D James, Linda M Gerber
Human biologists have been examining arterial blood pressure since they began studying the effects of the environment and culture on the health of diverse populations. The Korotkoff auscultatory technique with a trained observer and aneroid sphygmomanometer is the method of choice for blood pressure measurement in many bioanthropological field contexts. Korotkoff sounds (the first and fifth phases) are the preferred determinants of systolic and diastolic pressure, even in infants, children, pregnant women, and the elderly...
September 22, 2017: American Journal of Human Biology: the Official Journal of the Human Biology Council
https://www.readbyqxmd.com/read/28926754/training-needs-analysis-the-essential-first-step-for-continuing-professional-development-design
#9
Kathryn Holloway, Kerri Arcus, Georgina Orsborn
Nursing services are expected to be dynamic in response to changing health care needs. This expectation requires the purposeful and effective development of nursing workforce capability through continuing professional development (CPD). An evidence based approach to training needs analysis (TNA) is a highly recommended yet often missing first step in designing a CPD strategy for service improvement. This study used the Hicks-Hennessey questionnaire, a validated TNA tool to inform regional educational commissioning to meet the aims of a community social sector trial (SST) project...
September 5, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28926573/self-monitoring-of-blood-pressure-in-hypertension-a-systematic-review-and-individual-patient-data-meta-analysis
#10
REVIEW
Katherine L Tucker, James P Sheppard, Richard Stevens, Hayden B Bosworth, Alfred Bove, Emma P Bray, Kenneth Earle, Johnson George, Marshall Godwin, Beverly B Green, Paul Hebert, F D Richard Hobbs, Ilkka Kantola, Sally M Kerry, Alfonso Leiva, David J Magid, Jonathan Mant, Karen L Margolis, Brian McKinstry, Mary Ann McLaughlin, Stefano Omboni, Olugbenga Ogedegbe, Gianfranco Parati, Nashat Qamar, Bahman P Tabaei, Juha Varis, Willem J Verberk, Bonnie J Wakefield, Richard J McManus
BACKGROUND: Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension. METHODS AND FINDINGS: Medline, Embase, and the Cochrane Library were searched for randomised trials comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016)...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28901823/comics-as-a-medium-for-providing-information-on-adult-immunizations
#11
Jagannath M Muzumdar, Nicholas L Pantaleo
This study compared the following effects of two vaccine information flyers-one developed by the Centers for Disease Control and Prevention (CDC) versus one adapted from this information to a comic medium (comic)-on adults: (a) attitude toward the flyer; (b) perceived informativeness of the flyer; (c) intention to seek more information about adult immunizations after viewing the flyer; and (d) intention to get immunized after viewing the flyer. A between-group, randomized trial was used to randomly assign adults (age 18 years or older) at an ambulatory care center to review the CDC or comic flyer...
September 13, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28895659/implementation-strategies-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#12
REVIEW
Tomas Pantoja, Newton Opiyo, Simon Lewin, Elizabeth Paulsen, Agustín Ciapponi, Charles S Wiysonge, Cristian A Herrera, Gabriel Rada, Blanca Peñaloza, Lilian Dudley, Marie-Pierre Gagnon, Sebastian Garcia Marti, Andrew D Oxman
BACKGROUND: A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28894501/incorporating-assessment-and-prescribing-for-ambulatory-ailments-skills-into-practice-an-environmental-scan-of-continuing-education-for-pharmacist-prescribing-in-canada
#13
Dana Habicht, Sheila Ng, Drena Dunford, Brenna Shearer, I Fan Kuo
OBJECTIVES: Pharmacists in Canadian provinces are at different stages of applying prescribing legislation into practice. The purpose of this environmental scan was to examine differences in legislation, remuneration, professional uptake, continuing education requirements and continuing education resources relating to pharmacist prescribing for ambulatory ailments, with a focus on continuing education. METHODS: Data were collected between May and December 2016 using websites and communication with provincial professional regulatory bodies, advocacy bodies, drug coverage programs and other organizations that offer continuing education for pharmacists...
September 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28891393/improving-ambulatory-care-resident-training-preparing-for-opportunities-to-treat-mental-illness-in-the-primary-care-setting
#14
Nada M Farhat, Jolene R Bostwick, Stuart D Rockafellow
PURPOSE: The development of an outpatient psychiatry clinical practice learning experience for PGY2 ambulatory care pharmacy residents in preparation for the treatment of psychiatric disorders in the primary care setting is described. SUMMARY: With the increased prevalence of psychiatric disorders, significant mortality, and limited access to care, integration of mental health treatment into the primary care setting is necessary to improve patient outcomes. Given the majority of mental health treatment occurs in the primary care setting, pharmacists in patient-centered medical homes (PCMHs) are in a unique position with direct access to patients to effectively manage these illnesses...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28846993/objectively-measured-daily-physical-activity-and-postural-changes-as-related-to-positive-and-negative-affect-using-ambulatory-monitoring-assessments
#15
Daniel Aggio, Karen Wallace, Nicola Boreham, Aparna Shankar, Andrew Steptoe, Mark Hamer
OBJECTIVE: The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. METHODS: Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening...
September 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28842790/clinical-value-of-ambulatory-blood-pressure-in-pediatric-patients-after-renal-transplantation
#16
Rafael T Krmar, Jorge R Ferraris
Hypertension is a highly prevalent co-morbidity in pediatric kidney transplant recipients. Undertreated hypertension is associated with cardiovascular complications and negatively impacts renal graft survival. Thus, the accurate measurement of blood pressure is of the utmost importance for the correct diagnosis and subsequent management of post-renal transplant hypertension. Data derived from the general population, and to a lesser extent from the pediatric population, indicates that ambulatory blood pressure monitoring (ABPM) is superior to blood pressure measurements taken in the clinical setting for the evaluation of true mean blood pressure, identification of patients requiring antihypertensive treatment, and in the prediction of cardiovascular outcome...
August 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28842522/the-role-of-hyperglycemia-insulin-resistance-and-blood-pressure-in-diabetes-associated-differences-in-cognitive-performance-the-maastricht-study
#17
Stefan L C Geijselaers, Simone J S Sep, Danny Claessens, Miranda T Schram, Martin P J van Boxtel, Ronald M A Henry, Frans R J Verhey, Abraham A Kroon, Pieter C Dagnelie, Casper G Schalkwijk, Carla J H van der Kallen, Geert Jan Biessels, Coen D A Stehouwer
OBJECTIVE: To study to what extent differences in cognitive performance between individuals with different glucose metabolism status are potentially attributable to hyperglycemia, insulin resistance, and blood pressure-related variables. RESEARCH DESIGN AND METHODS: We used cross-sectional data from 2,531 participants from The Maastricht Study (mean age ± SD, 60 ± 8 years; 52% men; n = 666 with type 2 diabetes), all of whom completed a neuropsychological test battery...
August 25, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28841064/a-pain-education-intervention-for-patients-undergoing-ambulatory-inguinal-hernia-repair-a-randomized-controlled-trial
#18
Monakshi Sawhney, Judy Watt-Watson, Michael McGillion
Background Inguinal hernia repair is a common ambulatory surgery after which many patients experience moderate to severe post-operative pain. Limited research has examined the effect of education interventions to reduce pain after ambulatory surgery. Purpose This trial evaluated the effectiveness of an individualized Hernia Repair Education Intervention (HREI) for patients following inguinal hernia repair. Method Pre-operatively, participants (N = 82) were randomized to either the intervention (HREI) or the usual care group...
September 2017: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
https://www.readbyqxmd.com/read/28838362/improving-the-appropriate-use-of-transthoracic-echocardiography-the-echo-wisely-trial
#19
RANDOMIZED CONTROLLED TRIAL
R Sacha Bhatia, Noah M Ivers, X Cindy Yin, Dorothy Myers, Gillian C Nesbitt, Jeremy Edwards, Kibar Yared, Rishi K Wadhera, Justina C Wu, Aaron P Kithcart, Brian M Wong, Mark S Hansen, Adina S Weinerman, Steven Shadowitz, Debra Elman, Michael E Farkouh, Paaladinesh Thavendiranathan, Jacob A Udell, Amer M Johri, Chi-Ming Chow, Judith Hall, Zachary Bouck, Ashley Cohen, Kevin E Thorpe, Harry Rakowski, Michael H Picard, Rory B Weiner
BACKGROUND: Appropriate use criteria (AUC) have defined transthoracic echocardiogram (TTE) indications for which there is a clear lack of benefit as rarely appropriate (rA). OBJECTIVES: This study sought to investigate the impact of an AUC-based educational intervention on outpatient TTE ordering by cardiologists and primary care providers. METHODS: The authors conducted a prospective, investigator-blinded, multicenter, randomized controlled trial of an AUC-based educational intervention aimed at reducing rA outpatient TTEs...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28834845/primary-care-residents-in-teaching-health-centers-their-intentions-to-practice-in-underserved-settings-after-residency-training
#20
Zohray Talib, Mariellen Malloy Jewers, Julia H Strasser, David K Popiel, Debora Goetz Goldberg, Candice Chen, Hayden Kepley, Fitzhugh Mullan, Marsha Regenstein
PURPOSE: To describe the residents who chose to train in teaching health centers (THCs), which are community-based ambulatory patient care sites that sponsor primary care residencies, and their intentions to practice in underserved settings. METHOD: The authors surveyed all THC residents training in academic years 2013-2014, 2014-2015, and 2015-2016, comparing their demographic characteristics with data available for residents nationally, and examined THC residents' intentions to practice in underserved settings using logistic regression analysis...
August 22, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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