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https://www.readbyqxmd.com/read/29055029/cancer-incidence-in-adults-living-in-the-vicinity-of-nuclear-power-plants-in-france-based-on-data-from-the-french-network-of-cancer-registries
#1
Alice Desbiolles, Candice Roudier, Sarah Goria, Morgane Stempfelet, Cécile Kairo, Cécile Quintin, Marie-Laure Bidondo, Alain Monnereau, Blandine Vacquier
Nuclear power plants (NPPs) release toxic emissions into the environment that may affect neighboring populations. This ecologic study was designed to investigate the possibility of an excess incidence of cancer in the vicinity of French NPPs by examining the incidence by municipality of 12 types of cancer in the population aged 15 years and older during the 1995-2011 period. Population exposure to pollution was estimated on the basis of distance from towns of residence to the NPP. Using regression models, we assessed the risk of cancer in a 20-kilometer zone around NPPs and observed an excess incidence of bladder cancer (Relative Risk (RR), 95% Credibility Interval (95% CI)) in men and women (RRmen = 1...
October 21, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29054720/a-randomized-comparison-of-two-robotic-virtual-reality-simulators-and-evaluation-of-trainees-skills-transfer-to-a-simulated-robotic-urethrovesical-anastomosis-task
#2
Jen Hoogenes, Nathan Wong, Badr Al-Harbi, Kevin S Kim, Saahil Vij, Elisa Bolognone, Mackenzie Quantz, Yanbo Guo, Bobby Shayegan, Edward D Matsumoto
OBJECTIVE: To determine, via a randomized comparison study, whether robotic simulator-acquired skills transfer to performance of a urethrovesical anastomosis (UVA) on a 3D-printed bladder model using the da Vinci Robot. MATERIALS AND METHODS: Medical students, surgical residents, and fellows were recruited and divided into two groups: G1 (junior trainees) and G2 (senior trainees). Participants were randomized to identical simulator training curricula on the dV-Trainer (dV-T) or da Vinci Surgical Skills Simulator (dVSSS)...
October 17, 2017: Urology
https://www.readbyqxmd.com/read/29054462/communication-with-patients-and-the-duration-of-family-medicine-consultations
#3
Francisco Javier Valverde Bolívar, Miguel Pedregal González, Herminia Moreno Martos, Inmaculada Cózar García, Jesús Torío Durántez
OBJECTIVE: To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style. DESIGN: Cross-sectional multicentre study. LOCATION: Primary Healthcare Centres in Andalusia, Spain. PARTICIPANTS: A total of 119 tutors and family medicine physician residents. PRINCIPAL MEASUREMENTS: Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care...
October 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29053607/does-migration-limit-the-effect-of-health-insurance-on-hypertension-management-in-china
#4
Hai Fang, Yinzi Jin, Miaomiao Zhao, Huyang Zhang, John A Rizzo, Donglan Zhang, Zhiyuan Hou
Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance...
October 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29053183/impact-of-recent-medicaid-expansions-on-office-based-primary-care-and-specialty-care-among-the-newly-eligible
#5
Adam I Biener, Samuel H Zuvekas, Steven C Hill
OBJECTIVE: To quantify the effect of Medicaid expansions on office-based care among the newly eligible. DATA SOURCE: 2008-2014 Medical Expenditure Panel Survey. STUDY DESIGN: The main sample is adults age 26-64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference-in-differences linear probability models compare utilization between expansion and nonexpansion states and between 2008-2013 and 2014...
October 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29052915/disease-burden-of-mild-asthma-in-china
#6
Bo Ding, Mark Small
BACKGROUND AND OBJECTIVE: The impact, treatment patterns and control of mild asthma are poorly understood for Chinese patients. This study describes the characteristics, therapeutic interventions and burden of mild asthma on patients residing in major cities of China. METHODS: The Respiratory Disease Specific Program 2015, a cross-sectional survey, was conducted with Chinese physicians and their patients. The survey assessed clinical characteristics, asthma symptoms, exacerbations, rescue inhaler usage, treatment adherence, asthma control, work and activity impairments and healthcare utilization for patients prescribed Global Initiative for Asthma (GINA) Step 1 or 2 treatment defined mild asthma...
October 20, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29052691/discontinuing-inappropriate-medication-use-in-nursing-home-residents-a-cluster-randomized-controlled-trial
#7
Hans Wouters, Jessica Scheper, Hedi Koning, Chris Brouwer, Jos W Twisk, Helene van der Meer, Froukje Boersma, Sytse U Zuidema, Katja Taxis
Background: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use. Objective: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home residents. Design: Pragmatic cluster randomized controlled trial, with clustering by elder care physicians and their wards. (ClinicalTrials.gov: NCT01876095)...
October 10, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29052558/cesarean-section-rate-in-singleton-primiparae-and-related-factors-in-beijing-china
#8
Geng Song, Yu-Mei Wei, Wei-Wei Zhu, Hui-Xia Yang
BACKGROUND: The cesarean section rate (CSR) has been a main concern worldwide. The present study aimed to investigate the CSR in Beijing, China, and to analyze the related factors of CS delivery. METHODS: An observational study was conducted in 15 medical centers in Beijing using a systemic cluster sampling method. In total, 15,194 pregnancies were enrolled in the study between June 20, 2013 and November 30, 2013. Independent t-tests and Pearson's Chi-square test were used to examine differences between two groups, and related factors of the CSR were examined by multivariable logistic regression...
October 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29051898/accuracy-of-the-lever-sign-test-in-the-diagnosis-of-anterior-cruciate-ligament-injuries
#9
Keith A Jarbo, David E Hartigan, Kelly L Scott, Karan A Patel, Anikar Chhabra
BACKGROUND: The lever sign test is a new physical examination tool to diagnose anterior cruciate ligament (ACL) tears. Preliminary results suggest almost 100% sensitivity and specificity to diagnose acute and chronic complete ACL tears and clinically significant partial tears as compared with magnetic resonance imaging (MRI). PURPOSE: To assess the sensitivity and specificity of the lever sign test for the diagnosis of acute ACL injuries, as compared to MRI. We also aimed to determine the accuracy of the lever sign test compared with 3 other tests (anterior drawer, Lachman, and pivot shift) when performed by providers of various training levels, and with the patient awake or under anesthesia...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051721/a-comparison-of-medical-education-in-germany-and-the-united-states-from-applying-to-medical-school-to-the-beginnings-of-residency
#10
REVIEW
Dmitry Zavlin, Kevin T Jubbal, Jonas G Noé, Bernd Gansbacher
Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors' objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities...
2017: German Medical Science: GMS E-journal
https://www.readbyqxmd.com/read/29050964/surgical-site-infection-following-open-reduction-and-internal-fixation-of-a-closed-ankle-fractures-a-retrospective-multicenter-cohort-study
#11
Ran Sun, Mingqiao Li, Xiaofeng Wang, Xiaodong Li, Lumei Wu, Zheng Chen, Kang Chen
BACKGROUND: Identification of risk factors for surgical site infection (SSI) after surgical ankle fractures was important, but related evidence was inadequate. This study was conducted to investigate the incidence and risk factors for SSI after open reduction and internal fixation (ORIF) of a closed ankle fractures. METHODS: Patients who underwent ORIF for a closed ankle fractures at 3 centers between July 2015 and January 2017 were included. Electronic medical recordings (EMR) and Picture Archiving and Communication Systems (PACS) were inquired for information on patients' clinical and radiographic characteristics...
October 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29050952/a-research-coding-method-to-evaluate-medical-clinicians-conduct-of-behavioral-health-care-in-patients-with-unexplained-symptoms
#12
Katelyn A Grayson-Sneed, Robert C Smith
OBJECTIVE: Develop a reliable coding method of a Behavioral Health Treatment Model for patients with Medically Unexplained Symptoms (BHTM-MUS). METHODS: Two undergraduates trained for 30h coded videotaped interviews from 161 resident-simulated patient (SP) interactions. Trained on 45 videotapes, coders coded 33 (20%) of 161 study set tapes for the BHTM-MUS. Guetzkow's U, Cohen's Kappa, and percent of agreement were used to measure coders' reliability in unitizing and coding residents' skills for eliciting: education and informing (4 yes/no items), motivating (2), treatment statements (5), commitment and goals (2), negotiates plan (8), non-emotion patient-centered skills (4), and patient-centered emotional skills (8)...
October 12, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29049814/cost-effectiveness-of-testing-and-treatment-for-latent-tuberculosis-infection-in-residents-born-outside-the-united-states-with-and-without-medical-comorbidities-in-a-simulation-model
#13
Abriana Tasillo, Joshua A Salomon, Thomas A Trikalinos, C Robert Horsburgh, Suzanne M Marks, Benjamin P Linas
Importance: Testing for and treating latent tuberculosis infection (LTBI) is among the main strategies to achieve TB elimination in the United States. The best approach to testing among non-US born residents, particularly those with comorbid conditions, is uncertain. Objective: To estimate health outcomes, costs, and cost-effectiveness of LTBI testing and treatment among non-US born residents with and without medical comorbidities. Design, Setting, and Participants: Decision analytic tree and Markov cohort simulation model among non-US born residents with no comorbidities, with diabetes, with HIV infection, or with end-stage renal disease (ESRD) using a health care sector perspective with 3% annual discounting...
October 16, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29049674/collaboration-between-acgme-and-aoa-programs-to-enhance-success-in-the-single-accreditation-system-a-process-paper
#14
Amanda K H Weidner, Judith Pauwels, Marcia McGuire, Ardis Davis
Beginning in 2020, all residency programs will be accredited by the Accreditation Council for Graduate Medical Education (ACGME). Programs accredited by the American Osteopathic Association (AOA) that do not achieve ACGME pre-accreditation status by 2020 will be forced to close, resulting in loss of graduate medical education slots and affecting the physician workforce locally and nationally. Current ACGME programs are in a position to help consult, support, and learn from local AOA-only programs as they work toward meeting ACGME accreditation requirements, but to date there have been only limited collaborations...
October 19, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#15
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049278/illicit-drug-use-illicit-drug-use-disorders-and-drug-overdose-deaths-in-metropolitan-and-nonmetropolitan-areas-united-states
#16
Karin A Mack, Christopher M Jones, Michael F Ballesteros
PROBLEM/CONDITION: Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. REPORTING PERIOD: Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015...
October 20, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29049076/fatigue-risk-management-the-impact-of-anesthesiology-residents-work-schedules-on-job-performance-and-a-review-of-potential-countermeasures
#17
Lily R Wong, Erin Flynn-Evans, Keith J Ruskin
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048963/a-21st-century-public-health-approach-to-abortion
#18
Sarah C M Roberts, Liza Fuentes, Nancy F Berglas, Amanda J Dennis
In the United States, groups advocating for and against abortion rights often deploy public health arguments to advance their positions. Recently, these arguments have evolved into state laws that use the government health department infrastructure to increase law enforcement and regulatory activities around abortion. Many major medical and public health associations oppose these new laws because they are not evidence-based and do not protect women's health. Yet state health departments have been defending these laws in court...
October 19, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29046269/what-clinical-information-is-valuable-to-doctors-using-mobile-electronic-medical-records-and-when
#19
Junetae Kim, Yura Lee, Sanghee Lim, Jeong Hoon Kim, Byungtae Lee, Jae-Ho Lee
BACKGROUND: There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high. OBJECTIVE: The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such information is accessed...
October 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29045985/entry-of-medical-school-graduates-into-family-medicine-residencies-2016-2017
#20
Stanley M Kozakowski, Alexandra Travis, Julie P Marcinek, Ashley Bentley, Gerald T Fetter
This annual report is an expansion on previous reports in this series that provides further evidence that the current medical school system is failing, collectively, to produce the primary care workforce that is needed to achieve optimal health in the United States. Inclusion of data on the performance of DO-granting and international medical schools, creates a more complete and complex picture of the contribution of all medical school types to the primary care workforce that should allow stakeholders to set goals, identify institutions with models from which to learn, and develop strategies for continuous improvement...
October 2017: Family Medicine
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