19,030 results match your criteria Academic Physician & Scientist[Journal]


Deimplementation of Routine Chest X-rays in Adult Intensive Care Units.

J Hosp Med 2019 Feb;14(2):83-89

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Background: Choosing Wisely® is a national initiative to deimplement or reduce low-value care. However, there is limited evidence on the effectiveness of strategies to influence ordering patterns.

Objective: We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies. Read More

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http://dx.doi.org/10.12788/jhm.3129DOI Listing
February 2019

Patients' and Providers' Views on Causes and Consequences of Healthcare Fragmentation in the Ambulatory Setting: a Qualitative Study.

J Gen Intern Med 2019 Feb 19. Epub 2019 Feb 19.

Weill Cornell Medicine, New York, NY, USA.

Background: Patients with chronic conditions routinely see multiple outpatient providers, who may or may not communicate with each other. Gaps in information across providers caring for the same patient can lead to harm for patients. However, the exact causes and consequences of healthcare fragmentation are not understood well enough to design interventions to address them. Read More

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http://dx.doi.org/10.1007/s11606-019-04859-1DOI Listing
February 2019

Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey.

BMJ Open 2019 Feb 19;9(2):e023506. Epub 2019 Feb 19.

Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Objective: To determine the prevalence and associated factors for personal, work-related and patient/client-related burnout in clinical professionals and biomedical scientists in academic medicine.

Design: Prevalence survey using the Copenhagen Burnout Inventory.

Setting: Mid-size academic health centre. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023506DOI Listing
February 2019

The association between payment model and specialist physicians' selection of patients with diabetes: a descriptive study.

CMAJ Open 2019 Jan-Mar;7(1):E109-E116. Epub 2019 Feb 18.

Departments of Community Health Sciences (Quinn, McBrien, Hemmelgarn, Manns), Medicine (Edwards, Hemmelgarn, Tonelli, Au, Ma, Weaver, Manns) and Family Medicine (McBrien), University of Calgary, Calgary, Alta.; Department of Medicine (Senior), University of Alberta, Edmonton, Alta.

Background: As the number of people with chronic diseases increases, understanding the impact of payment model on the types of patients seen by specialists has implications for improving the quality and value of care. We sought to determine if there is an association between specialist physician payment model and the types of patients seen.

Methods: In this descriptive study, we used administrative data to compare demographic characteristics, illness severity and visit indication of patients with diabetes seen by fee-for-service and salary-based internal medicine and diabetes specialists in Calgary and Edmonton between April 2011 and September 2014. Read More

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http://dx.doi.org/10.9778/cmajo.20180171DOI Listing
February 2019

Qualitative study to elicit patients' and primary care physicians' perspectives on the use of a self-management mobile health application for knee osteoarthritis.

BMJ Open 2019 Feb 1;9(1):e024016. Epub 2019 Feb 1.

Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.

Objective: To elicit perspectives of family physicians and patients with knee osteoarthritis (KOA) on KOA, its treatment/management and the use of a mobile health application (app) to help patients self-manage their KOA.

Design: A qualitative study using Cognitive Task Analysis for physician interviews and peer-to-peer semistructured interviews for patients according to the Patient and Community Engagement Research (PaCER) method.

Setting: Primary care practices and patient researchers at an academic centre in Southern Alberta. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024016DOI Listing
February 2019

Classification of paroxysmal events and the four-dimensional epilepsy classification system.

Epileptic Disord 2019 Feb 18. Epub 2019 Feb 18.

Grenoble-Alpes Hospital and University - Neurology Department and GIN INSERM U-1216, Grenoble, France.

This educational review describes the classification of paroxysmal events and a four-dimensional epilepsy classification system. Paroxysmal events are classified as epileptic and non-epileptic paroxysmal events. Non-epileptic events are, in turn, classified as psychogenic and organic paroxysmal events. Read More

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http://dx.doi.org/10.1684/epd.2019.1033DOI Listing
February 2019

Antimicrobial stewardship in rural nursing homes: Impact of interprofessional education and clinical decision tool implementation on urinary tract infection treatment in a cluster randomized trial.

Infect Control Hosp Epidemiol 2019 Feb 20:1-6. Epub 2019 Feb 20.

Scientific Affairs,Canadian Agency for Drugs and Technologies in Health,Ottawa, Ontario,Canada.

Objectives: To measure the impact of an antimicrobial stewardship initiative on the rate of urine culture testing and antimicrobial prescribing for urinary tract infections (UTIs) between control and intervention sites. Secondary objectives included evaluation of potential harms of the intervention and identifying characteristics of the population prescribed antimicrobials for UTI.

Design: Cluster randomized controlled trial. Read More

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http://dx.doi.org/10.1017/ice.2019.9DOI Listing
February 2019

Obesity, gut hormones and knighthood.

Authors:
Stephen R Bloom

Expert Rev Endocrinol Metab 2013 May;8(3):225-227

a Imperial College London, South Kensington Campus, Exhibition Rd, London, SW7 2AZ, UK.

Interview by Rona Williamson Steve Bloom was born in Kent in 1942 and received his undergraduate medical training at Cambridge University, Cambridge, UK. His House Officer, Senior House Officer and Registrar posts were undertaken at The Middlesex Hospital where he also received an MRC Clinical Research training Fellowship. He moved to the Royal Postgraduate Medical School at Hammersmith Hospital as a Consultant Physician in 1974 where in due course he became Professor of Medicine. Read More

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http://dx.doi.org/10.1586/eem.13.17DOI Listing

Regenerating the field of cardiovascular cell therapy.

Nat Biotechnol 2019 Feb 18. Epub 2019 Feb 18.

Institute for Stem Cell Biology and Regenerative Medicine; Ludwig Center for Cancer Stem Cell Biology and Medicine; Departments of Pathology and Developmental Biology, Stanford University School of Medicine, Stanford, CA, USA.

The retraction of >30 falsified studies by Anversa et al. has had a disheartening impact on the cardiac cell therapeutics field. The premise of heart muscle regeneration by the transdifferentiation of bone marrow cells or putative adult resident cardiac progenitors has been largely disproven. Read More

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http://dx.doi.org/10.1038/s41587-019-0042-1DOI Listing
February 2019

Bi-allelic Variants in TONSL Cause SPONASTRIME Dysplasia and a Spectrum of Skeletal Dysplasia Phenotypes.

Am J Hum Genet 2019 Feb 11. Epub 2019 Feb 11.

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Hospital, Houston, TX 77030, USA. Electronic address:

SPONASTRIME dysplasia is an autosomal-recessive spondyloepimetaphyseal dysplasia characterized by spine (spondylar) abnormalities, midface hypoplasia with a depressed nasal bridge, metaphyseal striations, and disproportionate short stature. Scoliosis, coxa vara, childhood cataracts, short dental roots, and hypogammaglobulinemia have also been reported in this disorder. Although an autosomal-recessive inheritance pattern has been hypothesized, pathogenic variants in a specific gene have not been discovered in individuals with SPONASTRIME dysplasia. Read More

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http://dx.doi.org/10.1016/j.ajhg.2019.01.007DOI Listing
February 2019

What's in a Name? Provider Perception of Injured John Doe Patients.

J Surg Res 2019 Feb 14;238:218-223. Epub 2019 Feb 14.

Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

Background: We previously demonstrated that unidentified aliased patients, John Doe's (DOEs), are one of the highest risk and most medically fragile populations of injured patients. Aliasing can result in misplaced information and confusion that must be overcome by health care professionals. DOE alias use is institutionally dependent and not uniform, which may lead to significant variation in perception of confusion and error. Read More

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http://dx.doi.org/10.1016/j.jss.2019.01.027DOI Listing
February 2019

Non-technical attributes and surgical experience: a cross-sectional study comparing communication styles and attitudes in surgical staff, trainees and applicants.

Int J Surg 2019 Feb 12. Epub 2019 Feb 12.

Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.

Background: This monocentric study aimed to explore whether key non-technical attributes can be reliably measured in a mixed population of candidates applying for surgical training, surgical trainees and staff and to identify any differences between these groups.

Materials & Methods: Candidates applying for surgical training, surgical trainees and staff from four surgical specialties (general surgery, orthopedics, plastic surgery or urology) at a tertiary academic teaching hospital were all sent an online self-report questionnaire. The Communication Styles Inventory (CSI, 96 items) was used to assess a six-dimensional behavioral model of participant communication styles (expressiveness, preciseness, verbal aggressiveness, questioningness, emotionality and impression manipulativeness). Read More

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http://dx.doi.org/10.1016/j.ijsu.2019.02.002DOI Listing
February 2019

Alcohol consumption and cardiovascular health: A nationwide survey of Uruguayan cardiologists.

Alcohol 2019 Feb 12. Epub 2019 Feb 12.

Division of Cardiology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada. Electronic address:

Background And Aims: Heavy alcohol use is a risk factor for disease and mortality; however epidemiological findings have demonstrated protective effects of a light-to-moderate intake of alcohol on cardiovascular health. There are many misconceptions regarding appropriate levels of alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Uruguayan cardiologists. Read More

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http://dx.doi.org/10.1016/j.alcohol.2019.02.002DOI Listing
February 2019

Challenges Associated With Moving the United States Medical Licensing Examination (USMLE) Step 1 to After the Core Clerkships and How to Approach Them.

Acad Med 2019 Feb 12. Epub 2019 Feb 12.

A. Pock is associate dean for curriculum and associate professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. M. Daniel is assistant dean of curriculum and associate professor of emergency medicine and learning health sciences, University of Michigan School of Medicine, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0001-8961-7119. S.A. Santen is senior associate dean of evaluation, assessment, and scholarship of learning, and professor of emergency medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia. A. Swan-Sein is director, Center for Educational Research and Evaluation, and assistant professor of educational assessment, Columbia University Vagelos College of Physicians and Surgeons, New York, New York. A. Fleming is associate dean for medical student affairs and professor of pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee. V. Harnik is associate dean of curriculum and associate professor of cell biology, NYU School of Medicine, New York, New York.

An increasing number of medical schools have moved away from traditional 2 + 2 curricular structures toward curricula that intentionally integrate basic, clinical, and health systems science, with the goal of graduating physicians who consistently apply their foundational knowledge to clinical practice to improve the care of patients and populations. These curricular reforms often include a shortened pre-clerkship phase with earlier introduction of learners into clinical environments. This has led schools to reconsider the optimal timing of United States Medical Licensing Examination Step 1 exam. Read More

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http://dx.doi.org/10.1097/ACM.0000000000002651DOI Listing
February 2019

Content validity of the SOS-WRIST questionnaire for timely identification of wrist overuse in young athletes.

Phys Sportsmed 2019 Feb 15. Epub 2019 Feb 15.

b Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands.

Objectives Young athletes do not always seek medical help for overuse wrist injuries, risking invalidating long-term consequences resulting from late diagnosis. This study aimed to develop a questionnaire to identify overuse wrist injuries in young athletes. Methods According to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria, items were collected from literature and 6 focus groups of sports physicians and of young athletes with (previous) overuse wrist injuries. Read More

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http://dx.doi.org/10.1080/00913847.2019.1568788DOI Listing
February 2019
2 Reads

Practice patterns and outcomes with the use of regorafenib in metastatic colorectal cancer: Results from the Regorafenib in Metastatic colorectal cancer - An Indian exploratory analysis study.

South Asian J Cancer 2019 Jan-Mar;8(1):22-26

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Background: Regorafenib is considered a standard of care as third-line therapy in metastatic colorectal cancers (mCRCs).

Materials And Methods: The study was based on a computerized clinical data form sent to oncologists across the country for entry of anonymized patient data. The data entry form was conceived and generated by the coordinating center's (Tata Memorial Hospital) gastrointestinal medical oncologists and disseminated through personal contacts at academic conferences as well as through E-mail to various oncologists across India. Read More

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http://dx.doi.org/10.4103/sajc.sajc_173_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348777PMC
February 2019
1 Read

Role of Point-of-Care Ultrasonography in the Evaluation and Management of Kidney Disease.

Fed Pract 2018 Dec;35(12):27-33

, , , , and are Academic Nephrology Attending Physicians at the James A. Haley Veterans' Hospital and Assistant Professors at the University of South Florida Department of Nephrology and Hypertension, all in Tampa, Florida. At the time the article was written was a Medical Fellow at the University of South Florida.

Imaging at the nephrology point of care provides an important and continuously expanding tool to improve diagnostic accuracy in concert with history and physical examination. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366586PMC
December 2018

Self-reported influence of monetary grants in the choice of a medical residency in remote or under-served areas.

Isr J Health Policy Res 2019 Feb 15;8(1). Epub 2019 Feb 15.

Internal Medicine Department "T", Chaim Sheba Medical Center in Tel-Ha'Shomer, Ramat-Gan, Israel.

Objectives: To evaluate the effect of monetary grants on young physicians' choice of remote or rural hospital-based practice.

Background: In late 2011, The Israeli Ministry of Health attempted to address a severe physician maldistribution, which involved severe shortages in remotely-located institutions (RLI). The policy intervention included offering monetary grants to residents who chose a residency program in a RLI. Read More

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http://dx.doi.org/10.1186/s13584-018-0272-6DOI Listing
February 2019

Academic Life in Emergency Medicine Blog and Podcast Watch: Toxicologic Emergencies.

Cureus 2018 Dec 5;10(12):e3687. Epub 2018 Dec 5.

Emergency Medicine, University of South Carolina College of Medicine, Greenville, USA.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series was created in 2014 to address a lack of both curation of online educational content and a nationally available curriculum that meets individualized interactive instruction. Using an expert-based, crowdsourced approach, the AIR series identifies trustworthy, high-quality, educational blog and podcast content. Here, we summarize the content rated as high quality per our a priori criteria as evaluated by eight attending physicians. Read More

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http://dx.doi.org/10.7759/cureus.3687DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368425PMC
December 2018

The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement.

PLoS One 2019 13;14(2):e0212014. Epub 2019 Feb 13.

HuNamics, LLC, Palo Alto, CA, United States of America.

Background: Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212014PLOS
February 2019

The Seriousness of Chronic Venous Disease: A Review of Real-World Evidence.

Authors:
Alun H Davies

Adv Ther 2019 Feb 13. Epub 2019 Feb 13.

Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, UK.

Chronic venous disease (CVD) is a prevalent condition that tends to worsen with age. Patients initially seek treatment to relieve symptoms of leg pain, discomfort, heaviness and swelling, all of which impact their quality of life. As the disease increases in severity to include varicose veins, skin changes, and venous ulcer, the demand for treatment increases while the quality of life further diminishes. Read More

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http://dx.doi.org/10.1007/s12325-019-0881-7DOI Listing
February 2019
1 Read

Log2Lose: Development and Lessons Learned From a Mobile Technology Weight Loss Intervention.

JMIR Mhealth Uhealth 2019 Feb 13;7(2):e11972. Epub 2019 Feb 13.

William S Middleton Memorial Veterans Hospital, Madison, WI, United States.

Background: Providing financial incentives has gained popularity as a strategy to promote weight loss, but questions remain about how best to utilize them. A promising mobile health strategy provides users with near-real-time financial incentives based on both the process of weight loss (behavioral modification) and actual weight loss. To maximize the impact of this strategy, a methodology is needed to close the gap between the desired behavior and the financial incentive. Read More

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http://dx.doi.org/10.2196/11972DOI Listing
February 2019

Perioperative Management of Total Laryngectomy Patients: A Survey of American Head and Neck Society Surgeons.

Ann Otol Rhinol Laryngol 2019 Feb 13:3489419830118. Epub 2019 Feb 13.

2 Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, New York, NY, USA.

Objectives:: Standards of care for total laryngectomy (TL) patients in the postoperative period have not been established. Perioperative care remains highly variable and perhaps primarily anecdotally based. The aim of this study was to survey members of the American Head and Neck Society to capture management practices in the perioperative care of TL patients. Read More

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http://dx.doi.org/10.1177/0003489419830118DOI Listing
February 2019

Implementing an Inpatient Acupuncture Service for Pain and Symptom Management: Identifying Opportunities and Challenges.

J Altern Complement Med 2019 Feb 13. Epub 2019 Feb 13.

2 Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA.

Objective: To explore an interprofessional group of health care providers' perspectives on the facilitators and barriers to implementation of an inpatient acupuncture service for pain and symptom management.

Design: Qualitative.

Setting: An urban, academic, tertiary care health system. Read More

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http://dx.doi.org/10.1089/acm.2018.0348DOI Listing
February 2019
2 Reads

Twelve tips for improvement-oriented evaluation of competency-based medical education.

Med Teach 2019 Feb 13:1-6. Epub 2019 Feb 13.

b Cathexis Consulting , Toronto , Canada.

The shift to competency-based medical education (CBME) requires a new approach to program evaluation. CBME implementers need to embed evaluation in their programs to ensure their CBME adapts to the changing demands of the healthcare system. This 12 tips paper proposes that those advancing CBME use an improvement-oriented, utilization-focused approach to program evaluation. Read More

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http://dx.doi.org/10.1080/0142159X.2018.1552783DOI Listing
February 2019

A semi-automated whole exome sequencing workflow leads to increased diagnostic yield and identification of novel candidate variants.

Cold Spring Harb Mol Case Stud 2019 Feb 12. Epub 2019 Feb 12.

Children's Hospital Los Angeles;

Background: Advancing the clinical utility of whole exome sequencing (WES) for patients with suspected genetic disorders is largely driven by bioinformatics approaches that streamline data processing and analysis.

Methods: Herein, we describe our experience with implementing a semi-automated and phenotype-driven WES diagnostic workflow, incorporating both the DRAGEN pipeline and the Exomiser variant prioritization tool, at an academic children's hospital with an ethnically diverse pediatric patient population.

Results: We achieved a 41% molecular diagnostic rate for 66 duo-, quad- or trio- WES cases, and 28% for 40 singleton-WES cases. Read More

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http://dx.doi.org/10.1101/mcs.a003756DOI Listing
February 2019
1 Read

Facilitators and barriers to brokering between research and care by senior clinical-scientists in general practice and elderly care medicine.

Educ Prim Care 2019 Feb 12:1-8. Epub 2019 Feb 12.

a Julius Centre , University Medical Centre Utrecht, Utrecht University , Utrecht , The Netherlands.

Background: Clinician-scientists (CSs) are physicians who work in daily care and have an academic role in research or education. They may act as knowledge brokers and help to connect research and clinical practice. There is no data available on CSs' brokering activities and the perceived barriers and facilitators to optimising their role in general practice (GP) and elderly care medicine (EM). Read More

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http://dx.doi.org/10.1080/14739879.2019.1570349DOI Listing
February 2019
1 Read

A Commentary on Impact of Women-Focused Professional Organization and Academic Retention and Advancement: Perceptions from a Qualitative Study.

Acad Emerg Med 2019 Feb 12. Epub 2019 Feb 12.

University Central Florida, College of Medicine, Altamonte Springs, Florida.

Despite the steady increase in female medical students and female faculty in the US, there has been little change in the distribution of women across the ranks of assistant, associate, and full professor over the past 30 years. Women are substantially less likely than men to be full professors even after accounting for age, experience, specialty, and measures of research and clinical productivity. From 2009 to 2017, the percentage of female faculty in emergency medicine dropped from 3% to 1. Read More

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http://dx.doi.org/10.1111/acem.13712DOI Listing
February 2019

Adalimumab Effectiveness Up to Six Years in Adalimumab-naïve Patients with Crohn's Disease: Results of the PYRAMID Registry.

Inflamm Bowel Dis 2019 Feb 8. Epub 2019 Feb 8.

Academic Medical Center, Amsterdam, Netherlands.

Background: PYRAMID was an international multicenter, noninterventional, postmarketing registry assessing long-term safety and effectiveness of adalimumab (Humira), as used in routine clinical practice.

Methods: Adult patients with moderately to severely active Crohn's disease with or without prior adalimumab experience were enrolled in the registry and followed for up to 6 years. Effectiveness measurements included the Physician's Global Assessment (PGA, a composite of Harvey Bradshaw Index [HBI] and rectal bleeding score), clinical remission (HBI < 5), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and Work Productivity and Activity Impairment (WPAI) questionnaire. Read More

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http://dx.doi.org/10.1093/ibd/izz008DOI Listing
February 2019
3 Reads

Demonstrating advanced practice provider value: Implementing a new advanced practice provider billing algorithm.

J Am Assoc Nurse Pract 2019 Feb;31(2):93-103

Medical University of South Carolina, Charleston, South Carolina.

Background: Rapid changes in health care are driving the adjustment of work flow by which providers serve patients in team-based care. Specifically, there is a need to develop more effective and efficient utilization with accurate attribution of advanced practice providers' (APPs) productivity.

Local Problem: The Directors of the APP-Best Practice Center conducted assessments of each clinical area at MUSC Health, a large academic medical center. Read More

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http://dx.doi.org/10.1097/JXX.0000000000000155DOI Listing
February 2019

Trainee colonoscopy quality is influenced by the independent and unobserved performance characteristics of supervising physicians.

Endosc Int Open 2019 Jan 9;7(1):E74-E82. Epub 2019 Jan 9.

Division of Digestive and Liver Disease, Department of Medicine, Columbia University, New York, New York, USA.

 Endoscopy training remains an apprenticeship, and the characteristics that facilitate transfer of high quality procedural skills from role models to trainees are unknown. We sought to determine whether unobserved supervisor performance influences the quality of colonoscopy performed by trainees, by studying how supervisors perform alone and how trainees perform while under those same supervisors.  This was a retrospective cross-sectional study conducted among ambulatory adults ≥ 50 years old who underwent colonoscopy for cancer screening or polyp surveillance from 2006 to 2015 at one academic medical center. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0770-2646
Publisher Site
http://dx.doi.org/10.1055/a-0770-2646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368225PMC
January 2019
3 Reads

Variation in Laparoscopic Nephrectomy Surgical Costs: Opportunities for High Value Care Delivery.

Urol Pract 2018 Sep;5(5):334-341

Department of Urology, University of California, San Francisco, San Francisco, California.

Introduction: Rising health care costs are leading to efforts to minimize costs while maintaining high quality care. Practice variation in the operating room that is not dictated by patient necessity or clinical guidelines presents an opportunity for cost containment. We identified variation in surgical supply costs among urological surgeons performing laparoscopic nephrectomy and evaluated whether this variation was associated with patient outcomes. Read More

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http://dx.doi.org/10.1016/j.urpr.2017.09.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368220PMC
September 2018

Design, Implementation, and Evaluation of a Diversity Program for Radiology.

J Am Coll Radiol 2019 Feb 7. Epub 2019 Feb 7.

Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.

Rationale And Objectives: Diagnostic radiology training programs are less diverse than graduating US medical school classes and the patient populations they serve. Inclusion of physicians who are underrepresented minorities in medicine (URMM) can strengthen the profession and help to meet the needs of an increasingly diverse population. Our Department of Radiology developed and implemented a plan to increase the number of URMMs in our residency applicant pool and residency training program. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15461440183155
Publisher Site
http://dx.doi.org/10.1016/j.jacr.2018.12.007DOI Listing
February 2019
7 Reads

EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research.

Drugs Aging 2019 Feb 11. Epub 2019 Feb 11.

Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

Falls are a major public health concern in the older population, and certain medication classes are a significant risk factor for falls. However, knowledge is lacking among both physicians and older people, including caregivers, concerning the role of medication as a risk factor. In the present statement, the European Geriatric Medicine Society (EuGMS) Task and Finish group on fall-risk-increasing drugs (FRIDs), in collaboration with the EuGMS Special Interest group on Pharmacology and the European Union of Medical Specialists (UEMS) Geriatric Medicine Section, outlines its position regarding knowledge dissemination on medication-related falls in older people across Europe. Read More

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http://dx.doi.org/10.1007/s40266-018-0622-7DOI Listing
February 2019
2 Reads

Three Quality Improvement Initiatives Improved Performance of Rheumatoid Arthritis Disease Activity Measures in Electronic Health Records: Results from an Interrupted Time Series Study.

Arthritis Care Res (Hoboken) 2019 Feb 11. Epub 2019 Feb 11.

Division of Rheumatology, UCSF and the Veterans Affairs Medical Center - San Francisco, San Francisco, CA.

Objective: Applying treat to target strategies in the care of patients with rheumatoid arthritis (RA) is critical for improving outcomes, yet electronic health records (EHRs) have few features to facilitate this strategy. We evaluated the effect of three health-IT initiatives on performance of RA disease activity measures and outcomes in an academic rheumatology clinic.

Methods: We implemented three initiatives designed to facilitate performance of the Clinical Disease Activity Index (CDAI): an EHR flowsheet to input scores, peer performance reports, and an EHR SmartForm including a CDAI calculator. Read More

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http://dx.doi.org/10.1002/acr.23848DOI Listing
February 2019
1 Read

Common metabolic disorder (inborn errors of metabolism) concerns in primary care practice.

Ann Transl Med 2018 Dec;6(24):469

Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.

Inborn errors of metabolism (IEMs) are rare genetic or inherited disorders resulting from an enzyme defect in biochemical and metabolic pathways affecting proteins, fats, carbohydrates metabolism or impaired organelle function presenting as complicated medical conditions involving several human organ systems. They involve great complexity of the underlying pathophysiology, biochemical workup, and molecular analysis, and have complicated therapeutic options for management. Age of presentation can vary from infancy to adolescence with the more severe forms appearing in early childhood accompanied by significant morbidity and mortality. Read More

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http://dx.doi.org/10.21037/atm.2018.12.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331353PMC
December 2018
2 Reads

Not just a specimen: A qualitative study of emotion, morality, and professionalism in one medical school gross anatomy laboratory.

Anat Sci Educ 2019 Feb 10. Epub 2019 Feb 10.

Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. Read More

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http://dx.doi.org/10.1002/ase.1868DOI Listing
February 2019
1 Read

Detection of distant metastatic disease by positron emission tomography with F-fluorodeoxyglucose (FDG-PET) at initial staging of cervical carcinoma.

Int J Gynecol Cancer 2019 Feb 9. Epub 2019 Feb 9.

Department of Radiation Oncology, Washington University in Saint Louis, St Louis, Missouri, USA

Objective: The detection of distant metastatic disease in cervical cancer patients at diagnosis is critical in accurate prognostication and directing treatment strategies. This study describes the frequency and sites of distant metastatic disease at diagnosis in patients with cervical cancer as detected by positron emission tomography with F-fluorodeoxyglucose (FDG-PET).

Methods: Patients with newly diagnosed cervical cancer underwent pre-treatment whole-body FDG-PET starting in 1997 at an academic institution. Read More

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http://dx.doi.org/10.1136/ijgc-2018-000108DOI Listing
February 2019
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Addressing Family Medicine's Capacity to Improve Health Equity Through Collaboration, Accountability and Coalition-Building.

Fam Med 2019 02;51(2):198-203

University of Alabama College of Community Health Services

Achieving health equity requires an evaluation of social, economic, environmental, and other factors that impede optimal health for all. Family medicine has long valued an ecological perspective of health, partnering with families and communities. However, both the quantity and degree of continued health disparities requires that family medicine intentionally work toward improvement in health equity. Read More

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http://dx.doi.org/10.22454/FamMed.2019.921819DOI Listing
February 2019

"Ultrasound guided incisionless carpal tunnel release using a hook knife: a cadaveric study".

PM R 2019 Feb 7. Epub 2019 Feb 7.

Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment mono-neuropathy of the median nerve. In comparison to open surgical and endoscopic carpal tunnel release, a new ultrasound guided hook knife carpal tunnel release (CTR) procedure was reported to have superior results in terms of reduced morbidity and early return to work.

Objective: To evaluate the reproducibility of the hook knife CTR procedure when performed by musculoskeletal ultrasound trained physicians without a prior experience in this technique. Read More

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http://dx.doi.org/10.1002/pmrj.12118DOI Listing
February 2019
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Parental career expectations: effect on medical students' career attitudes over time.

Med Educ 2019 Feb 7. Epub 2019 Feb 7.

Western Sydney University, School of Medicine, Campbelltown, New South Wales, Australia.

Background: Motivation to become a doctor has typically been conceived as arising from personal interests. However, it is not uncommon, particularly amongst those from collectivist cultures, for career choice to be motivated by a desire or need to fulfil parent expectations. Whether or not this motivation has longer term effects on the career satisfaction and performance of medical students is unknown. Read More

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http://dx.doi.org/10.1111/medu.13812DOI Listing
February 2019

Impact of Age on the Efficacy and Safety of Alirocumab in Patients with Heterozygous Familial Hypercholesterolemia.

Cardiovasc Drugs Ther 2019 Feb 8. Epub 2019 Feb 8.

Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Purpose: This post-hoc analysis examined whether age modified the efficacy and safety of alirocumab, a PCSK9 inhibitor, in patients with heterozygous familial hypercholesterolemia (HeFH), using pooled data from four 78-week placebo-controlled phase 3 trials (ODYSSEY FH I, FH II, LONG TERM, and HIGH FH).

Methods: Data from 1257 patients with HeFH on maximally tolerated statin ± other lipid-lowering therapies were analyzed by an alirocumab dose regimen and by age subgroups (18 to < 45, 45 to < 55, 55 to < 65, and ≥ 65 years). In the FH I and II trials, patients received 75 mg subcutaneously every 2 weeks (Q2W), with dose increase to 150 mg Q2W at week 12 if week 8 low-density lipoprotein cholesterol (LDL-C) was ≥ 70 mg/dl. Read More

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http://dx.doi.org/10.1007/s10557-019-06852-6DOI Listing
February 2019

Industry payments to physician journal editors.

PLoS One 2019 7;14(2):e0211495. Epub 2019 Feb 7.

University of California, San Francisco, California, United States of America.

Background: Open Payments is a United States federal program mandating reporting of medical industry payments to physicians, increasing transparency of physician conflicts of interest (COI). Study objectives were to assess industry payments to physician-editors, and to compare their financial COI rate to all physicians within the specialty.

Methods And Findings: We performed a retrospective analysis of prospectively collected data, reviewing Open Payments from August 1, 2013 to December 31, 2016. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211495PLOS
February 2019

Building High-Performing Teams in Academic Surgery: The Opportunities and Challenges of Inclusive Recruitment Strategies.

Acad Med 2019 Feb 5. Epub 2019 Feb 5.

L.A. Dossett is assistant professor, Department of Surgery, University of Michigan, Ann Arbor, Michigan. M.W. Mulholland is chair and professor, Department of Surgery, University of Michigan, Ann Arbor, Michigan. E.A. Newman is assistant professor and associate chair for faculty development, Department of Surgery, University of Michigan, Ann Arbor, Michigan.

Problem: In academic surgery, women and physicians from ethnic minority groups remain inadequately represented relative to their representation in the US population and among medical students and surgical trainees. While several initiatives have been aimed at developing the academic surgery pipeline or addressing issues related to faculty retention and promotion, little is known about how recruitment practices impact diversity in academic medicine. Moreover, national standards and ideal practices specific for effective recruitment in surgery have not been established. Read More

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http://dx.doi.org/10.1097/ACM.0000000000002647DOI Listing
February 2019

Defining Trainee Competence: Value is in the Eye of the Stakeholder.

Authors:
Lalena M Yarris

Acad Med 2019 Feb 5. Epub 2019 Feb 5.

L.M. Yarris is professor and residency program director, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.

In this issue of Academic Medicine, Lundsgaard and colleagues present "Embracing Multiple Stakeholder Perspectives in Defining Trainee Competence," a qualitative exploration of how various stakeholders contribute to the understanding of trainee competence. Drawing on stakeholder theory from business management, the authors of that report explore how the perceptions of key stakeholders (leaders/administrators, nurses/nurse practitioners, trainees, and patients) either confirm, enhance, or complicate the picture of competence that emerges from the perspectives of senior physician supervisors.In this Invited Commentary, the author considers the potential effects of applying stakeholder theory to educational assessment and elaborates on Lundsgaard and colleagues' findings that additional stakeholder perceptions may be redundant in some instances and present conflicting understandings of competence in others. Read More

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http://dx.doi.org/10.1097/ACM.0000000000002643DOI Listing
February 2019

(Dis)Incentivizing Patient Satisfaction Metrics: The Unintended Consequences of Institutional Bias.

Health Equity 2019 4;3(1):13-18. Epub 2019 Feb 4.

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Patient satisfaction surveys as a metric for quality-based financial incentives carry a risk of bias toward women and underrepresented physicians. Previous assessments in our department of medicine found that most women faculty were rated in the bottom quartile of patient satisfaction scores, whereas analysis of scores for underrepresented physicians had not been performed. To investigate, we compared patient satisfaction scores and relevant demographics of faculty physicians during 1 year when quality-related financial incentives were offered based on this metric. Read More

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http://dx.doi.org/10.1089/heq.2018.0065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363594PMC
February 2019

Canadian and UK/Ireland practice patterns in lumbar puncture performance in febrile neonates with bronchiolitis.

Emerg Med J 2019 Feb 6. Epub 2019 Feb 6.

Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.

Background: Serious bacterial infections in young infants with bronchiolitis are rare. Febrile infants <1 month old with bronchiolitis often receive a lumbar puncture (LP), despite limited data for this practice and lack of clinical practice guidelines for this population. The primary objective was to investigate practice patterns in performance of LPs in the ED management of febrile infants aged ≤30 days with bronchiolitis. Read More

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http://dx.doi.org/10.1136/emermed-2018-208000DOI Listing
February 2019
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Controlled clinical trial comparing the effectiveness of a mindfulness and self-compassion 4-session programme versus an 8-session programme to reduce work stress and burnout in family and community medicine physicians and nurses: MINDUUDD study protocol.

BMC Fam Pract 2019 Feb 6;20(1):24. Epub 2019 Feb 6.

Family and Community Medicine Teaching Unit of Córdoba. Lucena II Health Centre, Córdoba, Spain.

Background: Health personnel are susceptible to high levels of work stress and burnout due to the psychological and emotional demands of their work, as well as to other aspects related to the organisation of that work. This paper describes the rationale and design of the MINDUUDD study, the aim of which is to evaluate the effectiveness of a mindfulness and self-compassion 4-session programme versus the standard 8-session programme to reduce work stress and burnout in Family and Community Medicine and Nursing tutors and residents.

Methods: The MINDUDD study is a multicentre cluster randomised controlled trial with three parallel arms. Read More

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http://dx.doi.org/10.1186/s12875-019-0913-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364464PMC
February 2019
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Characterizing electronic health record usage patterns of inpatient medicine residents using event log data.

PLoS One 2019 6;14(2):e0205379. Epub 2019 Feb 6.

Department of Medicine, Stanford University, Stanford, California, United States of America.

Amid growing rates of burnout, physicians report increasing electronic health record (EHR) usage alongside decreasing clinical facetime with patients. There exists a pressing need to improve physician-computer-patient interactions by streamlining EHR workflow. To identify interventions to improve EHR design and usage, we systematically characterize EHR activity among internal medicine residents at a tertiary academic hospital across various inpatient rotations and roles from June 2013 to November 2016. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205379PLOS
February 2019
3.234 Impact Factor

Current state of the art and emerging pharmacotherapy for uterine leiomyosarcomas.

Expert Opin Pharmacother 2019 Feb 6:1-11. Epub 2019 Feb 6.

a Academic Unit of Obstetrics and Gynecology , IRCCS Ospedale Policlinico San Martino , Genoa , Italy.

Introduction: Uterine leiomyosarcomas (ULMS) account for 1% of all uterine malignancies and for 30% of all uterine sarcomas. The preoperative diagnosis of ULMS is challenging for the physicians, as the symptoms of these tumors are often vague and nonspecific. Moreover, as ULMS have an aggressive biologic behavior, affected women frequently have very poor prognosis. Read More

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http://dx.doi.org/10.1080/14656566.2019.1571042DOI Listing
February 2019
4 Reads
3.534 Impact Factor