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https://www.readbyqxmd.com/read/28441679/the-drivers-of-discretionary-utilization-clinical-history-versus-physician-supply
#1
Gregory W Ruhnke, Willard G Manning, David T Rubin, David O Meltzer
PURPOSE: Because the effect of physician supply on utilization remains controversial, literature based on non-Medicare populations is sparse, and a physician supply expansion is under way, the potential for physician-induced demand across diverse populations is important to understand. A substantial proportion of gastrointestinal endoscopies may be inappropriate. The authors analyzed the impact of physician supply, practice patterns, and clinical history on esophagogastroduodenoscopy (EGD, defined as discretionary) among patients hospitalized with lower gastrointestinal bleeding (LGIB)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441678/the-addiction-recovery-clinic-a-novel-primary-care-based-approach-to-teaching-addiction-medicine
#2
Stephen R Holt, Nora Segar, Dana A Cavallo, Jeanette M Tetrault
PROBLEM: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. APPROACH: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#3
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/28441636/psychological-features-and-quality-of-life-in-50-adult-patients-with-epilepsy-and-their-caregivers-from-the-lecco-epilepsy-center-italy
#4
Alessandra Petruzzi, Andrea Rigamonti, Claudia Yvonne Finocchiaro, Paolo Borelli, Elena Lamperti, Antonio Silvani, Rossana Regazzoni, Lorenzo Stanzani, Andrea Salmaggi
Epilepsy is one of the most common neurological disorders. To the best of our knowledge, in Italy, the relationship between patients' and caregivers' psychological state has rarely been analyzed. Thus, we sought to evaluate both the psychological state of patients with epilepsy and that of their caregivers and the interrelationship between them. We also assessed the existing relation between psychological features and some clinical and demographic information, such as number of antiepileptic drugs (AEDs), epilepsy duration and education level of patients and their caregivers...
April 22, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#5
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28441448/development-and-validation-of-a-modified-korean-version-of-the-pharmacy-services-questionnaire-psq-k-for-the-quality-assessment-of-community-pharmacy-services
#6
Kyung Im Kim, Hae Sun Suh, Arim Kwak, Siin Kim, Nayoung Han, Euni Lee, Jung Mi Oh
Patient-reported outcome (PRO) measures and validated instruments have become integral in assessing the quality of healthcare delivery, including pharmaceutical care services. The Pharmacy Services Questionnaire (PSQ) measures patient satisfaction with pharmaceutical care. In this study, we developed a modified Korean version of the PSQ (PSQ-K) and evaluated its validity and reliability. The PSQ-K was developed using a strict translation and cultural-adaptation procedure. A validation study was performed in six community pharmacies in Korea...
2017: PloS One
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#7
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28440993/-training-of-institutional-research-networks-as-a-strategy-of-improvement
#8
María Eugenia Galván-Plata, Eduardo Almeida-Gutiérrez, Fabio Abdel Salamanca-Gómez
The Instituto Mexicano del Seguro Social (IMSS) through the Coordinación de Investigación en Salud (Health Research Council) has promoted a strong link between the generation of scientific knowledge and the clinical care through the program Redes Institucionales de Investigación (Institutional Research Network Program), whose main aim is to promote and generate collaborative research between clinical, basic, epidemiologic, educational, economic and health services researchers, seeking direct benefits for patients, as well as to generate a positive impact on institutional processes...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28440892/the-effect-of-adult-early-warning-systems-education-on-nurses-knowledge-confidence-and-clinical-performance-a-systematic-review
#9
REVIEW
Mohamad M Saab, Bridie McCarthy, Tom Andrews, Eileen Savage, Frances J Drummond, Nuala Walshe, Mary Forde, Dorothy Breen, Patrick Henn, Jonathan Drennan, Josephine Hegarty
AIMS: This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. BACKGROUND: Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognise and manage deteriorating patients. Little is known as to the effectiveness of these programmes. DESIGN: SYSTEMATIC REVIEW: DATA SOURCES: Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October - November 2015...
April 25, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28440854/neuroprotective-diets-are-associated-with-better-cognitive-function-the-health-and-retirement-study
#10
Claire T McEvoy, Heidi Guyer, Kenneth M Langa, Kristine Yaffe
OBJECTIVES: To evaluate the association between the Mediterranean diet (MedDiet) and the Mediterranean-DASH diet Intervention for Neurodegeneration Delay (MIND diet) and cognition in a nationally representative population of older U.S. adults. DESIGN: Population-based cross-sectional study. SETTING: Health and Retirement Study. PARTICIPANTS: Community-dwelling older adults (N = 5,907; mean age 67.8 ± 10.8). MEASUREMENTS: Adherence to dietary patterns was determined from food frequency questionnaires using criteria determined a priori to generate diet scores for the MedDiet (range 0-55) and MIND diet (range 0-15)...
April 25, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28440674/late-talkers-and-later-language-outcomes-predicting-the-different-language-trajectories
#11
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/28440607/is-height-of-prognostic-significance-in-breast-cancer-cases
#12
Yasemin Benderli Cihan
Objective: The objective of this study was to investigate the correlation of height with prognosis and other prognostic factors in Turkish breast cancer cases. Materials and Methods: We retrospectively reviewed a total of 393 women aged between 26 and 88 years, diagnosed with stage 1-3 invasive ductal breast cancer, treated and followed-up in Kayseri Education and Research Hospital. Findings: The mean age at admission was 55.7 years; 77.6% were aged under 65, 56.7% were postmenopausal, 97.4% had undergone modified radical mastectomy, 47...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28440560/parental-perception-of-child-s-body-mass-index-and-health-within-primary-care
#13
Imelda Reyes, Melinda Higgins
BACKGROUND AND PURPOSE: Overweight and obesity are sensitive issues to address with pediatric patients during any visit. Patients and families may not recognize that their child is overweight or obese and may not be ready to make change. The goals for this study were to collect overall statistics on the clinic in regards to weight status of children presenting for well child visits and to capture parental perception of the child's weight status in relation to child's age. METHODS: A consecutive sample of parents and caregivers with a child aged 2-18 completed the survey and consented for the study on the day of the survey during a well child visit...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28440111/quality-of-life-outcomes-in-a-pediatric-thalassemia-population-in-egypt
#14
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/28440094/small-group-activities-within-academic-communities-improve-the-connectedness-of-students-and-faculty
#15
Katharina Brandl, Stephen D Schneid, Sunny Smith, Babbi Winegarden, Jess Mandel, Carolyn J Kelly
BACKGROUND: The University of California, San Diego, School of Medicine implemented a curriculum change that included reduction of lectures, incorporation of problem-based learning and other small group activities. Six academic communities were introduced for teaching longitudinal curricular content and organizing extracurricular activities. METHODS: Surveys were collected from 904 first- and second-year medical students over 6 years. Student satisfaction data with their sense of connectedness and community support were collected before and after the implementation of the new curriculum...
April 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28440039/effect-of-photoactivation-on-the-reduction-of-composite-resin-contamination
#16
Natalia A Pauletti, Luiza P S Girotto, Françoise H S Leite, Débora N Mario
Composite resins are predominantly marketed in developing countries in tube form, and the contents of the tube may be used in numerous procedures for different patients. This represents a problem because of the risk of cross-contamination. This study aimed to evaluate contamination in vitro of the internal contents of composite resin tubes in the dental clinics of a higher-education institution, as well as the effect of photoactivation on the level of contamination. Twenty-five tubes containing composite resin were randomly chosen (by lottery)...
April 24, 2017: European Journal of Oral Sciences
https://www.readbyqxmd.com/read/28439904/adaptation-and-validation-of-the-oral-health-literacy-instrument-for-the-chilean-population
#17
Ricardo A Cartes-Velásquez, Luis Luengo Machuca
OBJECTIVE: To report the adaptation and cultural validation of the Oral Health Literacy Instrument (OHLI) for the adult Chilean population attending public and university health services. STUDY DESIGN: The original OHLI in English was translated to Spanish and back-translated, then a preliminary version was obtained following review by four experts. A pilot study was carried out in 30 patients, who were asked to assess their understanding of the questionnaire. The following variables were included: sociodemographic factors (sex, age, average monthly income, education and marital status); oral health (history of caries, periodontal disease and oral hygiene); oral health-related quality of life; health literacy; oral health literacy; and psychometric properties (internal consistency, temporal stability, convergent validity and predictive validity)...
April 24, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28439886/lifebox-pulse-oximeter-implementation-in-malawi-evaluation-of-educational-outcomes-and-impact-on-oxygen-desaturation-episodes-during-anaesthesia
#18
V Albert, S Mndolo, E M Harrison, E O'Sullivan, I H Wilson, I A Walker
Pulse oximetry is an essential monitor for safe anaesthesia but is often not available in low-income countries. The aim of this study was to determine whether the introduction of pulse oximetry with training was feasible and could reduce the incidence of oxygen desaturation during anaesthesia in a low-income country. Pulse oximeters were donated, with training, to 83 non-physician anaesthetists in Malawi. Knowledge was tested immediately before and after training and at follow-up. Providers were asked to record the lowest peripheral oxygen saturation (SpO2 ) for the first 100 cases anaesthetised after training...
April 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28439604/emergency-presentation-of-colorectal-cancer-in-northwestern-saudi-arabia
#19
Ibrahim A Albalawi, Ahmad A Abdullah, Mohammed E Mohammed
To investigate the frequency and clinical characteristics of emergency presentation of colorectal carcinoma (CRC) in Tabuk Region of Saudi Arabia.  Methods: This is a retrospective, descriptive hospital-based study. All cases with CRC that presented to the main referral hospitals in Tabuk, Saudi Arabia between 2010 and 2015 were retrieved. The relevant hospitals are: King Salman Military Hospital, King Khalid Hospital, and King Fahad Hospital.  Results: Seventy-three patients were included in the study...
May 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28439581/lower-educational-level-is-a-risk-factor-for-tooth-loss-analysis-of-a-swiss-population-krebs-project
#20
Fabiola-Regina Rodriguez, Nadine Paganoni, Roland Weiger, Clemens Walter
PURPOSE: To analyse risk factors for tooth loss in women and men seeking treatment at the University of Basel, Switzerland. MATERIALS AND METHODS: Records of patients from the pool of patients at the department were consecutively screened between January 2009 and October 2011. Gender, smoking habits, education, profession, general health status and dental variables were recorded. Tooth loss was assessed on full-mouth periapical radiographs. Gender-nested logistic regression models were applied for statistical analysis...
2017: Oral Health & Preventive Dentistry
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