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Medical education autonomy

Leo H Wang, Michael A Elliott, Lily Jung Henson, Elba Gerena-Maldonado, Susan Strom, Sharon Downing, Jennifer Vetrovs, Paige Kayihan, Piper Paul, Kate Kennedy, Joshua O Benditt, Michael D Weiss
OBJECTIVES: To describe the amyotrophic lateral sclerosis (ALS) patients who sought medication under the Washington State Death with Dignity (DWD) Act since its inception in 2009. METHODS: Chart review at 3 tertiary medical centers in the Seattle/Puget Sound region and comparison to publicly available data of ALS and all-cause DWD cohorts from Washington and Oregon. RESULTS: In Washington State, 39 patients with ALS requested DWD from the University of Washington, Virginia Mason, and Swedish Medical Centers beginning in 2009...
October 21, 2016: Neurology
Herman Veenker, Wolter Paans
BACKGROUND: Research within the framework of Self-Determination Theory (SDT) indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing communication and interaction interventions in health literacy curricula for medical and health care practitioners, focusing on patient-oriented skills in "making sense" and "to adapt and self-manage"...
October 21, 2016: BMC Medical Education
E B Quinlivan, L C Messer, K Roytburd, A Blickman
The levels of satisfaction of the core self-determination needs (relatedness, autonomy and competence) among HIV-infected women of color as well as the association between need fulfillment and patient characteristics were examined. Having less than a high-school education was associated with lowest need satisfaction: autonomy (β = -1.90; 95%CI = -3.20, -0.60), relatedness (β = -2.70; 95%CI = -4.30, -1.10) and competency (β = -2.50; 95%CI = -3.60, -1.30). Each additional point increase in affective symptoms of depression was associated with decrements in need satisfaction (-...
October 13, 2016: AIDS Care
Christoph U Correll, Leslie Citrome, Peter M Haddad, John Lauriello, Mark Olfson, Stephen M Calloway, John M Kane
Long-acting injectable antipsychotics (LAIs) are among the most effective treatments in psychiatry, yet they remain underutilized in clinical practice. Although LAIs are typically used to maintain treatment adherence in patients with chronic schizophrenia, recent research has suggested that they may also provide an effective treatment strategy for patients with early-phase or first-episode disease. In October 2015, a group of 8 experts on the management of schizophrenia and LAIs met to evaluate the evidence surrounding the efficacy, safety, and cost-effectiveness of LAIs and to develop practical recommendations regarding the clinical use, education, and unmet needs related to LAIs...
2016: Journal of Clinical Psychiatry
V Soler, S Sourdet, L Balardy, G Abellan van Kan, D Brechemier, M E Rougé-Bugat, N Tavassoli, M Cassagne, F Malecaze, F Nourhashémi, B Vellas
OBJECTIVES: To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. DESIGN: Retrospective, observational cross-sectional, single-centre study. SETTING: Institutional practice. PARTICIPANTS: Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648)...
2016: Journal of Nutrition, Health & Aging
Aurelie Vouilloz, François Luthi
OBJECTIVE: A lower limb amputation is a major event for a patient with many questions arising for him and his family. Individual and environmental factors could influence patient's quality of life and adaptation to amputation. Most of the time brochures concern post operative care after limb amputation (surgery type, stump medical care, prosthetics…). Rehabilitation is often only briefly dealt with these brochures. OBJECTIVES OF THIS STUDY: (1) To write a brochure specifically concerning rehabilitation for lower limb amputees...
September 2016: Annals of Physical and Rehabilitation Medicine
Anne-Sophie Dolez, Azahara Alcantara, Romain Mouny
The Montévrain clinic wants to be a medical center oriented towards autonomy and recovery of patient autonomy, reintegration within the family, as well as social and professional reintegration. After studying the care offer and the population base in Seine et Marne, we wanted to get involved in order to improve the capacity of patients treated for breast cancer, suffering deconditioning, with or without joint limitation and functional impairment, with or without a mental deterioration. We studied the recommendations of the "plan cancer III", researched the tertiary phase of cancer treatment and studied literature about evaluation of the physical and mental condition...
September 2016: Annals of Physical and Rehabilitation Medicine
Kara N Goldman, Jamie A Grifo
PURPOSE OF REVIEW: Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation...
September 24, 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
Alemi Kebede, Kalkidan Hassen, Aderajew Nigussie Teklehaymanot
BACKGROUND: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. OBJECTIVE: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia...
2016: International Journal of Women's Health
Ciara McGlade, Edel Daly, Joan McCarthy, Nicola Cornally, Elizabeth Weathers, Rónán O'Caoimh, D William Molloy
BACKGROUND: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. RESEARCH AIM: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. RESEARCH DESIGN: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families...
September 16, 2016: Nursing Ethics
Dawn M Elfenbein
Importance: In the surgical community, there is concern that general surgery residents are choosing subspecialty training in large numbers because of a crisis in confidence at the end of training. Confidence is an essential quality of surgeons, and recent studies have attempted to quantify and measure it in graduating general surgery residents. Objectives: To systematically review the quality of evidence provided and to critically analyze the language used to describe the findings using quantitative methods...
September 7, 2016: JAMA Surgery
Marie A Navickis, Kathleen Mathieson
Patients with complex medical conditions require collaboration among multiple health care providers, and dental hygienists must be prepared to communicate effectively with medical providers to provide comprehensive quality patient care. The aim of this study was to assess U.S. dental hygiene students' attitudes about interprofessional collaboration (IPC) and identify any differences based on age, year in program, and program location. Participants were limited to students enrolled in dental hygiene associate degree programs across the United States...
September 2016: Journal of Dental Education
Marilyn J Hammer
The history of informed consent dates back as early as the 16th century (Selek, 2010). The current tenets of informed consent pertaining to the ethical conduct of research on human participants predominately stems from the 1947 Nuremberg Code (National Institutes of Health, 2016), which was created following the Nuremberg trials at the end of World War II. The unethical conduct of research on human participants during the Holocaust, coupled with experiments (e.g., the Tuskegee syphilis study), prompted a more formalized structure for ensuring the well-being and autonomy of human participants in research studies...
September 1, 2016: Oncology Nursing Forum
Christina Riechel, Anna Christina Alegiani, Sascha Köpke, Jürgen Kasper, Michael Rosenkranz, Götz Thomalla, Christoph Heesen
BACKGROUND: Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls...
2016: Patient Preference and Adherence
Stacey A Page, Kiran Pohar Manhas, Daniel A Muruve
BACKGROUND: Personal health information and biospecimens are valuable research resources essential for the advancement of medicine and protected by national standards and provincial statutes. Research ethics and privacy standards attempt to balance individual interests with societal interests. However these standards may not reflect public opinion or preferences. The purpose of this study was to assess the opinions and preferences of patients with kidney disease about the use of their health information and biospecimens for medical research...
2016: BMC Medical Ethics
Mohammad Habibullah Pulok, Md Nasim-Us Sabah, Jalal Uddin, Ulrika Enemark
BACKGROUND: Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011...
2016: BMC Pregnancy and Childbirth
Maria-Mădălina Bodescu, Adina Magdalena Turcanu, Maria-Cristina Gavrilescu, T Mihăescu
UNLABELLED: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory affection of the whole lung, characterized by an accelerated loss of the pulmonary functions, that reduces the patients' independence and stops them from having a normal, active life. The medical rehabilitation is considered "Third class rehabilitation", after preventive medicine and pharmaceutical medicine, and the respiratory rehabilitation recovery represents a complex structure of service addressing to patients with chronic pulmonary illnesses whose aim is to optimize the physical performances, psycho-social and autonomy...
October 2015: Pneumologia: Revista Societății Române de Pneumologie
Annouschka M Weijsenfeld, Colette Smit, Sophie Cohen, Ferdinand W N M Wit, Michelle Mutschelknauss, Linda C van der Knaap, Laura M van Zonneveld, Bert J Zomer, Nike Nauta, Joke C Patist, Marien H J Kuipers-Jansen, Esther P Smit, Charlotte Blokhuis, Dasja Pajkrt
BACKGROUND: As a result of effective combination antiretroviral therapy (cART) and advanced supportive healthcare, a growing number of human immunodeficiency virus (HIV)-infected children survive into adulthood. The period of transition to adult care is often associated with impaired adherence to treatment and discontinuity of care. We aimed to evaluate virological and social outcomes of HIV-infected adolescents and young adults (AYAs) before and after transition, and explore which factors are associated with virological failure...
October 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Danny Bega, Dimitri Krainc
Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care...
September 2016: Annals of Neurology
Girma Tsinuel, Asaminew Tsedeke, Siebeck Matthias, Martin R Fischer, Fabian Jacobs, Desalegn Sebsibe, Mamo Yoseph, Haileamlak Abraham
INTRODUCTION: One urgent goal of countries in sub-Saharan Africa is to dynamically scale up the education and work force of medical doctors in the training institutions and health facilities, respectively. These countries face challenges related to the rapid scale up which is mostly done without proper strategic planning, without the basic elements of infrastructure development, educational as well as academic and administrative human resources. Medical education done in the context of limited resources is thus compromising the quality of graduates...
May 2016: Ethiopian Journal of Health Sciences
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