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  1 / 107535 MEDLINE  
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PMID:29496803
Autor:Duong MT; Cothron AE; Lawson NC; Doherty EH
Dirección:Dr. Duong is Assistant Professor, Center for Advanced Oral Health, Arizona School of Dentistry & Oral Health, A.T. Still University; Ms. Cothron is a biostatistician at the University of Texas Health Science Center at San Antonio; Dr. Lawson is Assistant Professor, Division of Biomaterials, Scho
Título:U.S. Dental Schools' Preparation for the Integrated National Board Dental Examination.
Fuente:J Dent Educ; 82(3):252-259, 2018 Mar.
ISSN:1930-7837
País de publicación:United States
Idioma:eng
Resumen:An Integrated National Board Dental Examination (INBDE) combining basic, behavioral, and clinical sciences will be implemented in 2020 to replace the current two-part National Board Dental Examination required for all candidates who seek to practice dentistry in the U.S. The aims of this study were to determine how U.S. dental schools are preparing for implementation of the INBDE and to assess their top administrators' attitudes about the new exam. A total of 150 deans, academic deans, and other administrators at all 64 U.S. dental schools with graduating classes in 2016 were emailed a 19-question electronic survey. The survey questions addressed the respondents' level of support, perceived benefits and challenges, and planned preparation strategies for the INBDE. The individual response rate was 59%, representing 57 of the 64 schools. Approximately 60% of the respondents either agreed or strongly agreed that they support the integrated exam, while roughly 25% either somewhat or strongly disagreed. While most respondents (72%) reported that their institutions would be prepared for the INBDE, 74% reported that the merged exam created additional strain for their institutions. Respondents reported viewing content integration and clinical applicability as benefits of the INBDE, while required curriculum changes and student preparedness and stress were seen as challenges. Most of the respondents reported their schools were currently employing strategies to prepare for the INBDE including meetings with faculty and students and changes to curricula and course content. The beginning of the fourth year and the end of the third year were the most frequently reported times when schools planned to require students to take the INBDE, although almost half of the respondents did not yet know what it would be required at their school. Several schools were reconsidering using the boards as a passing requirement. This study found that support for the INBDE was not universal, but strategies are under way to prepare students, faculty, and curricula for this new means of assessment.
Tipo de publicación:JOURNAL ARTICLE


  2 / 107535 MEDLINE  
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PMID:29437655
Autor:English T; Ribeiro B
Dirección:Oxford, UK tenglish@doctors.org.uk ribeirob@parliament.uk.
Título:Should doctor assisted dying be legal?
Fuente:BMJ; 360:k562, 2018 02 07.
ISSN:1756-1833
País de publicación:England
Idioma:eng
Tipo de publicación:JOURNAL ARTICLE


  3 / 107535 MEDLINE  
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PMID:29385203
Autor:Cook DA; Pencille LJ; Dupras DM; Linderbaum JA; Pankratz VS; Wilkinson JM
Dirección:Knowledge Delivery Center, Mayo Clinic, Rochester, Minnesota, United States of America.
Título:Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants.
Fuente:PLoS One; 13(1):e0191943, 2018.
ISSN:1932-6203
País de publicación:United States
Idioma:eng
Resumen:OBJECTIVE: To understand clinicians' beliefs about practice variation and how variation might be reduced. METHODS: We surveyed board-certified physicians (N = 178), nurse practitioners (N = 60), and physician assistants (N = 12) at an academic medical center and two community clinics, representing family medicine, general internal medicine, and cardiology, from February-April 2016. The Internet-based questionnaire ascertained clinicians' beliefs regarding practice variation, clinical practice guidelines, and costs. RESULTS: Respondents agreed that practice variation should be reduced (mean [SD] 4.5 [1.1]; 1 = strongly disagree, 6 = strongly agree), but agreed less strongly (4.1 [1.0]) that it can realistically be reduced. They moderately agreed that variation is justified by situational differences (3.9 [1.2]). They strongly agreed (5.2 [0.8]) that clinicians should help reduce healthcare costs, but agreed less strongly (4.4 [1.1]) that reducing practice variation would reduce costs. Nearly all respondents (234/249 [94%]) currently depend on practice guidelines. Clinicians rated differences in clinician style and experience as most influencing practice variation, and inaccessibility of guidelines as least influential. Time to apply standards, and patient decision aids, were rated most likely to help standardize practice. Nurse practitioners and physicians assistants (vs physicians) and less experienced (vs senior) clinicians rated more favorably several factors that might help to standardize practice. Differences by specialty and academic vs community practice were small. CONCLUSIONS: Clinicians believe that practice variation should be reduced, but are less certain that this can be achieved. Accessibility of guidelines is not a significant barrier to practice standardization, whereas more time to apply standards is viewed as potentially helpful.
Tipo de publicación:JOURNAL ARTICLE


  4 / 107535 MEDLINE  
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PMID:29236902
Autor:Zanin LE; Albuquerque IMN; Carneiro MDSM; Melo DH
Dirección:Universidade Federal do Ceará - UFC - Sobral (CE), Brasil.
Título:Evaluation of speech-language pathology care in the family health strategy from user perspective.
Título:Avaliação da assistência fonoaudiológica na estratégia de saúde da família pela perspectiva do usuário..
Fuente:Codas; 29(6):e20160192, 2017 Dec 07.
ISSN:2317-1782
País de publicación:Brazil
Idioma:por; eng
Resumen:PURPOSE: To evaluate the satisfaction of users assisted by speech-language pathologists during their Multi-professional Residency in Family Health, considering the structural, organizational and relational categories. METHODS: Qualitative assessment conducted with 30 Family Health Strategy (FHS) users. Data were analyzed using Bardin's content analysis. RESULTS: The organizational category presented aspects associated with the organization of speech-language pathology (SLP) services, describing the specific practice and role of speech-language therapists in the FHS, as well as referral and waiting time for care, speech-language therapy actions, clarification of problems, and promotion of self-care. The relational category showed the relationship between residents and users, with emphasis on humanized care and bonding. The structural category described the dimensioning of speech-language pathologists in the FHS and the aspects related to the resources available in the health unit. CONCLUSION: User satisfaction was associated with the rapid access to the service and the humanized care provided by the residents, promoting a welcoming service and bonding between residents and community. User dissatisfaction was associated with the reduced number of speech-language pathologists available at FHS.
Tipo de publicación:JOURNAL ARTICLE


  5 / 107535 MEDLINE  
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PMID:29194680
Autor:Jenkins S; Ives J; Avery S; Draper H
Título:Who gets the gametes? An argument for a points system for fertility patients.
Fuente:Bioethics; 32(1):16-26, 2018 01.
ISSN:1467-8519
País de publicación:England
Idioma:eng
Resumen:This paper argues that the convention of allocating donated gametes on a 'first come, first served' basis should be replaced with an allocation system that takes into account more morally relevant criteria than waiting time. This conclusion was developed using an empirical bioethics methodology, which involved a study of the views of 18 staff members from seven U.K. fertility clinics, and 20 academics, policy-makers, representatives of patient groups, and other relevant professionals, on the allocation of donated sperm and eggs. Against these views, we consider some nuanced ways of including criteria in a points allocation system. We argue that such a system is more ethically robust than 'first come, first served', but we acknowledge that our results suggest that a points system will meet with resistance from those working in the field. We conclude that criteria such as a patient's age, potentially damaging substance use, and parental status should be used to allocate points and determine which patients receive treatment and in what order. These and other factors should be applied according to how they bear on considerations like child welfare, patient welfare, and the effectiveness of the proposed treatment.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T


  6 / 107535 MEDLINE  
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PMID:29203733
Autor:Derkowski T; Kosinski S; Podsiadlo P; Sanak T; Salapa K; Wejnarski A; Galazkowski R; Darocha T
Dirección:Lotnicze Pogotowie Ratunkowe, Warszawa, Polska.
Título:[Assessment of knowledge about hypothermia among the medical personnel of polish medical air rescue].
Fuente:Wiad Lek; 70(5):875-880, 2017.
ISSN:0043-5147
País de publicación:Poland
Idioma:pol
Resumen:Polish Medical Air Rescue is tasked to deal with the most serious incidents associated with life threatening situations, in multiple circumstances. As a consequence, medical personnel have to meet high standards of education and show a continuous theoretical and practical development of the skills which are necessary during medical treatment. Thanks to the introduction of ECMO treatment for accidental hypothermia patients, new clinical and operational possibilities have arisen, so more patients can be saved with a very good neurological outcome. AIM: To analyze the data on hypothermia collected by the personnel of Polish Medical Air Rescue and to assess the e-learning platform as an educational tool. MATERIALS AND METHODS: 123 persons were involved. The subject of analysis were the e-learning platform results of the Polish Medical Air Rescue medical personnel. The e-learning consisted of a pre-test, 8 lessons followed by MCQ's (multi choice questions) and a post-test. RESULTS AND CONCLUSIONS: We could not prove a statistically significant difference in the knowledge about hypothermia between doctors and other medical professionals. Post-traumatic hypothermia and associated coagulation disturbances are two important topics requiring particular focus during the design of further educational and training projects. As a consequence of the training, both groups significantly improved their knowledge: i.e. a statistically significant improvement of knowledge about hypothermia between pre-test and post-test results in both groups was shown. The hypothermia e-learning platform for medical personnel is an effective educational tool.
Tipo de publicación:JOURNAL ARTICLE


  7 / 107535 MEDLINE  
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PMID:28449049
Autor:Banerjee S; Califano R; Corral J; de Azambuja E; De Mattos-Arruda L; Guarneri V; Hutka M; Jordan K; Martinelli E; Mountzios G; Ozturk MA; Petrova M; Postel-Vinay S; Preusser M; Qvortrup C; Volkov MNM; Tabernero J; Olmos D; Strijbos MH
Dirección:Gynaecology Unit Royal Marsden Hospital NHS Foundation Trust, Institute of Cancer Research, London.
Título:Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey.
Fuente:Ann Oncol; 28(7):1590-1596, 2017 Jul 01.
ISSN:1569-8041
País de publicación:England
Idioma:eng
Resumen:Background: Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). Methods: A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Results: Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). Conclusions: This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
Tipo de publicación:JOURNAL ARTICLE; MULTICENTER STUDY


  8 / 107535 MEDLINE  
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PMID:28460130
Autor:Ochoa A; Kitayama K; Uijtdehaage S; Vermillion M; Eaton M; Carpio F; Serota M; Hochman ME
Dirección:UCLA PRIME, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Título:Patient and provider perspectives on the potential value and use of a bilingual online patient portal in a Spanish-speaking safety-net population.
Fuente:J Am Med Inform Assoc; 24(6):1160-1164, 2017 Nov 01.
ISSN:1527-974X
País de publicación:England
Idioma:eng
Resumen:Objective: To assess patient and provider perspectives on the potential value and use of a bilingual patient portal in a large safety-net health system serving predominantly Spanish-speaking patients. Materials and Methods: We captured patient and provider perspectives through the administration of surveys to assess Internet access, barriers, and facilitators to patient portal adoption, along with portal preferences. We report on these survey results using descriptive and comparative statistics. Results: Four hundred patients (82% response rate) and 59 providers (80% response rate) participated in the study. Although 73% of providers believed that the patient portal would increase patient satisfaction, just 39% planned to recommend portal use to patients, citing concerns related to time and reimbursement. In contrast, 72% of patients believed the patient portal would strengthen the patient-provider relationship and 77% believed it would improve the quality of care. Latino patients in particular believed the patient portal would strengthen the patient-provider relationship. Seventy-five percent of patients reported interest in a mobile version of the portal. Discussion: Patients from a safety-net health system, most of whom were Spanish-speaking, reported a high level of interest in the patient portal. Providers at the same health system expressed reluctance about the portal due to concerns related to time and reimbursement. Conclusion: Bilingual patient portal implementation has considerable potential to promote health care engagement within Spanish-speaking safety-net populations; however, lack of provider engagement in the process could undermine the effort.
Tipo de publicación:JOURNAL ARTICLE


  9 / 107535 MEDLINE  
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PMID:28460016
Autor:Kathirvel S; Tripathy JP; Tun ZM; Patro BK; Singh T; Bhalla A; Devnani M; Wilkinson E
Dirección:Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Título:Physicians' compliance with the National Drug Policy on Malaria in a tertiary teaching hospital, India, from 2010 to 2015: a mixed method study.
Fuente:Trans R Soc Trop Med Hyg; 111(2):62-70, 2017 02 01.
ISSN:1878-3503
País de publicación:England
Idioma:eng
Resumen:Background: National drug policies are formulated to encourage rational use of drugs and to reduce drug resistance. This study assessed physicians' compliance with the National Drug Policy on Malaria at a tertiary care hospital in north India. Methods: This mixed method study extracted data from adult malaria inpatient records of the hospital from 2010-2015, and assessed drug supply at pharmacies. Physicians' practices and perspectives were explored by in-depth interviews. Compliance was assessed by severity, type of species and pregnancy status. Thematic analysis was done for the qualitative data. Results: A total of 247 case files were reviewed. Vivax malaria (41.0%) was more common than falciparum malaria (37.2%). The majority (90.8%) of cases were severe malaria. Overall compliance for use of schizonticidal drug was 73.0% in severe malaria and was only 9.5% in uncomplicated malaria. Compliance for use of gametocidal drug (primaquine) was 15.3%. Schizonticidal drugs were available in all pharmacies except the public one. Primaquine was available in only one. The main themes emerging in the thematic network analysis were physicians' misconceptions, physician-related factors, and hospital-related and drug access factors. Conclusions: The degree of compliance for severe malaria treatment was reasonably good but low for radical cure. Raising knowledge and awareness among health care providers, by using written treatment protocols and continuing medical education would improve compliance.
Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Nombre de substancia:0 (Antimalarials)


  10 / 107535 MEDLINE  
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PMID:28453829
Autor:Tereanu C; Smith SA; Sampietro G; Sarnataro F; Mazzoleni G; Pesenti B; Sala LC; Cecchetti R; Arvati M; Brioschi D; Viscardi M; Prati C; Barbaglio GG
Dirección:Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Via Borgo Palazzo n. 130, 24125 Bergamo, Italy.
Título:Experimenting the hospital survey on patient safety culture in prevention facilities in Italy: psychometric properties.
Fuente:Int J Qual Health Care; 29(2):269-275, 2017 Apr 01.
ISSN:1464-3677
País de publicación:England
Idioma:eng
Resumen:Objective: The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities. Design: After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out. Setting: Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy. Participants: Census of medical and non-medical staff (n. 479). Intervention: Web-based self-administered questionnaire. Main outcome measures: Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites. Results: Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant. Conclusions: Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.
Tipo de publicación:JOURNAL ARTICLE



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