This paper contributes to a small but growing body of evidence regarding the efficacy of value-based insurance design. In a retrospective, observational study of employees of a large global pharmaceutical firm, we evaluated how reduced patient cost sharing for prescription drugs for asthma, hypertension, and diabetes affected the use of ...

Prescribing for older adults has become increasingly complex as treatment regimens have intensified, and the use of herbal and over-the-counter medications has increased. This article describes an educational intervention called Geriatrics Medication Management Rounds, which uses a new and comprehensive assessment tool called the Medication Screening Questionnaire (MSQ). This case-based ...

To examine the current medical management of arteriopathic patients attending a vascular surgical service at a university teaching hospital over a 6-month period. The prescribing of antiplatelets, statins, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers and beta-blockers was specifically examined. Vascular patients are often under the care of multiple ...

Adverse drug events can occur as a result of handoffs in patient care. To reduce the possibility of this occurring, the process of medication reconciliation (whereby the patient's medication history is compared to current and previous medications to ensure accuracy) is becoming recognized as becoming increasingly important. To address this, ...

Three cases of international medical travelers from Yemen, a capital‐poor country in the southwest corner of the Arabian Peninsula, help to counter misconceptions within discussions of medical tourism. These misconceptions include the suggestion of leisure in medical tourism, the role of gender and class, and the ease with which we ...

Moral reasoning is important for developing medical professionalism but current evidence for the relationship between education and moral reasoning does not clearly apply to medical students. We used a combined study design to test the effect of clinical teaching on moral reasoning. We used the Defining Issues Test-2 as a ...

This study uses a cost construction model to estimate the cost of a four-year undergraduate medical education at the University of Texas-Houston Medical School (UT-Houston) in 2006-2007 compared to 1994-1995. The model computes the cost by measuring increasingly inclusive definitions of the educational mission: instructional (direct-contact teaching), educational (instructional plus ...

Studies in cognitive psychology inform us that the recall of information and its application are best when it is taught and rehearsed in environments similar to workplace. The healthcare professions are heavily task- and performance-based where non-technical skills, decision making and clinical reasoning are important alongside integrity, empathy and compassion. ...

There has been much debate over the last two decades about professionalism in medicine. Opinions are diverse but, problematically, most are from the academic and medical viewpoints. There is substantially less discourse from the public perspective. To explore the Dunedin public's perspective of important professional qualities in the medical profession. ...

This study examined the diagnosis, race, age, and conviction offenses of those using walking canes at California Medical Facility through a random review of 40 charts and 40 conviction folders. Motivating factors were concern about the potential for misuse of canes as weapons and a desire to further understand the ...

Personalised written action plans are increasingly regarded as an important component of chronic obstructive pulmonary disease (COPD) self-management support and yet they may not be understood by those with limited literacy skills. This study was designed to produce a comprehensible pictorial COPD action plan for use by patients and health ...

Statistical methods are pervasive in medical research and general medical literature. Understanding general statistical concepts will enhance our ability to critically appraise the current literature and ultimately improve the delivery of patient care. This article intends to provide an overview of the common statistical methods relevant to medicine.

Over the past 25 years, professionalism has emerged as a substantive and sustained theme, the operationalization and measurement of which has become a major concern for those involved in medical education. However, how to go about establishing the elements that constitute appropriate professionalism in order to assess them is difficult. ...

Background: Competence consists of a range of skills, knowledge and attitudes that physicians utilize in their work. Different models for defining physician competency areas have been used in medical organizations. The goal of this study was to explore how Finnish physicians perceive the need for different competency areas in their ...

Two current surveys of graduating medical students and/or recently graduated physicians from the United Kingdom raise significant concerns about the quality and quantity of clinical pharmacology instruction. Compared with the relative abundance of information about the instruction of basic pharmacology in US medical schools, little information exists about similar curricular ...

This paper seeks to examine an intervention program which was developed in order to improve the performance and skills of technical medical personnel at the military recruitment medical committees. Evaluation of the technician soldiers' performance was carried out by the usage of a specifically farmed survey, comprising a designed questionnaire, ...

An important issue facing medical education concerns whether integrating the bioscientific basis of medical practice and research with other subject matter in so-called 'self-directed learning approaches' will ensure that medical graduates meet the needs of the 21st century. Although it may be possible to continue to integrate the more traditional ...

The aim of this study was to determine if use of an ultrasonic bladder-scanning device reduced the number of urinary catheters inserted in a medical-surgical unit of an acute care facility. A stratified random sample of adult patients on a 28-bed medical-surgical unit at Northcrest Medical Center, located in Springfield ...

Emergency peripartum hysterectomy (EPH), is performed when life-threatening obstetric conditions occur. The authors attempt to assess the incidence of EPH as well as to investigate risk factors and patients' characteristics. A retrospective study of all cases of EPH performed at the 2nd Department of Obstetrics and Gynecology, Medical School of ...

Abstract:Of all the principles set out by Flexner in 1910, the most fundamental, that of academic and scientific excellence, is more relevant to medical education in the United Kingdom today than ever before. To realize this, undergraduate medical education (UGME) at Oxford has evolved to incorporate the tutorial method of ...

Background: The United Kingdom Clinical Aptitude Test (UKCAT) is used by 23 UK medical schools. Research to date has focused on validity and utility but it is also critical to examine selection processes from the applicant's perspective. Methods: This was a mixed-methods study using a paper-based survey and focus groups ...

The concept of a medical home is receiving increased attention as a potential means to improve care and reduce costs. This study describes the characteristics and capabilities of practices that have achieved recognition of National Committee for Quality Assurance as a "patient-centered medical home" (PCMH). Both small and large practices ...

A 109-year-old woman was hospitalized with myocardial infarction in the geriatric long-term care ward of our hospital. Her medical history was unknown, and she was receiving only peroral 20 mg/day furosemide. Her medical records at another hospital revealed that she had been given a previous diagnosis of myocardial infarction of ...

Abstract:The Flexner Report highlighted the importance of teaching medical students to reason about uncertainty. The science of medical decision making seeks to explain how medical judgments and decisions ought ideally to be made, how they are actually made in practice, and how they can be improved, given the constraints of ...

This study reports the findings of research undertaken by health sciences librarians at the University of Queensland Library into how medical students use information for their studies, particularly resources and services provided by the Library. The methods utilized were an online survey and focus groups. Results indicated that students favor ...

The purpose of this study was to evaluate the effectiveness of a high-probability (high-p) request sequence as a means of increasing compliance with medical examination tasks. Participants were children who had been diagnosed with autism and who exhibited noncompliance during general medical examinations. The inclusion of the high-p request sequence ...

Background: Replication studies evaluate technologies in usual use settings. Methods: We conducted a clinical trial to determine whether reductions in clinical and economic results observed in a previous study could be replicated in a larger setting. Subjects were randomized to receive intervention (email notifications for sentinel health events sent to ...

Abstract:Background: Community health workers (CHWs) are frontline public health workers who connect immigrant communities with health care services. Although CHW asthma interventions have been shown to improve some outcomes, their ability to change medication adherence remains unclear.Objective: Our goal was to determine if intensive asthma medication training resulted in objective ...

Despite a substantial proportion of international medical graduates (IMG) matching to U.S. programs in Internal Medicine, little is known about their readiness in the six medical competencies compared to graduates of U.S. schools (USMG). A brief questionnaire with two questions designed to assess basic understanding of each of the six ...

Background: Despite the traditional focus being adverse drug reactions (ADRs), pharmacovigilance centres have recently been identified as a potentially rich and important source of medication error data. Objective: To identify medication errors in the New Zealand Pharmacovigilance database (Centre for Adverse Reactions Monitoring [CARM]), and to describe the frequency and ...

Pediatric patients require special attention from pediatric pharmacists. This is particularly true for pediatric patients with chronic kidney disease (CKD) as the number of their medications and the complexity of their treatment increase with disease progression. However, there is paucity of information describing pediatric cognitive pharmacy services in this setting. ...

To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients. Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered ...

The widespread availability of the internet and development of online learning technology has seen electronic learning become a key part of medical education. This study examines the current situation in the delivery of e-learning solely to final year medical students by UK medical schools. A total of 25 UK medical ...

Background: Systemic review of predictors of success in medical career is an important tool to recognize the indicators of proper training. Aim: To determine psychological factors that predict success in a medical career. The success is defined as professional competence, satisfaction with medicine as a career, occupational stress and burnout ...

Following the emergence of 2009 pandemic influenza A(H1N1) virus (pH1N1) in the United States, the incidence of pH1N1 in the community was unclear, because not all persons with influenza come to medical attention. To better estimate the incidence of pH1N1 in the community early in the pandemic, a telephone survey ...

Coccidioidomycosis is caused by Coccidioides species, a fungus endemic to the desert regions of the southwestern United States, and is of particular concern for African Americans. We performed a PubMed search of the English-language medical literature on coccidioidomycosis in African Americans and summarized the pertinent literature. Search terms were coccidioidomycosis, ...

In the care of children with autism spectrum disorders (ASD), medical treatment is typically considered an adjunct to educational and behavioral interventions. Nonetheless, large proportions of children with ASD are managed medically and receive both pharmacologic and complementary-alternative medicine (CAM) treatments. Although many medical treatments have been studied in children ...

Background: Medical Ethics is structured to guide doctors towards a better professional practice. However, its teaching in medical schools seems to be neglected. Aim: To evalúate the perception of Federal University of Sergipe medical students about ethical conflicts duringtheir academic practice, in two different periods of a medical course. Material ...

A new report by the American Medical Association reveals why medical liability claims are so devastating and costly for America's doctors: just over 42% of all physicians and an astonishing 57% of physicians in surgical subspecialties have been sued. Nearly 61% of physicians aged 55 or older have faced the ...

This is Sudan's first cross sectional exploratory study aimed to analyze the appropriateness of prescriptions written in different health settings in Wad Medani, Sudan. Two pretested questionnaires were used to collect information about the possible causes of medication errors from randomly selected practicing physicians and pharmacists. The sample consisted of ...

The use of pharmacy delivery robots in an institution's intensive care units was evaluated. In 2003, the University of Maryland Medical Center (UMMC) began a pilot program to determine the logistic capability and functional utility of robotic technology in the delivery of medications from satellite pharmacies to patient care units. ...

This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes ...

Background: The oral case presentation (OCP) is a fundamental communication skill that frequently is taught as part of internal medicine clerkships. However, little is known about the optimal content for an OCP. Purpose: We hypothesized that internal medicine clinician-teachers have common expectations regarding OCPs by 3rd-year medical students. Methods: We ...

The therapeutic benefit of self-administered medications for long-term use is limited by an average 50% nonadherence rate. Patient forgetfulness is a common factor in unintentional nonadherence. Unit-of-use packaging that incorporates a simple day-and-date feature (calendar packaging) is designed to improve adherence by prompting patients to maintain the prescribed dosing schedule. ...

Advances in pediatric health care have prolonged lives and improved the quality of life for children and adolescents. These advances include not only high-tech devices and new medications but also re-application of available medications to take advantage of unexpected benefits which may not have been known previously or even side ...

Innovative approaches are needed to support patients' adherence to drug therapy. The Real Time Medication Monitoring (RTMM) system offers real time monitoring of patients' medication use combined with short message service (SMS) reminders if patients forget to take their medication. This combination of monitoring and tailored reminders provides opportunities to ...

General practitioners and medical specialists mainly rely on one "general medical" journal to keep their medical knowledge up to date. Nevertheless, it is not known if these journals display the same overview of the medical knowledge in different specialties. The aims of this study were to measure the relative weight ...

Stroke is a major cause of death and leading cause of disability in the United States. To maximize a stroke patient's chances of receiving thrombolytic treatment for acute ischemic stroke, it is important to improve prehospital recognition of stroke. However, it is known from published reports that emergency medical dispatchers ...

Health care databases are a valuable source for epidemiological research in respiratory diseases if diagnoses are valid. We validated the International Classification of Diseases, 10th revision (ICD-10) diagnosis of pleural empyema in the Danish National Registry of Patients (DNRP). We randomly selected hospitalized patients registered in the DNRP with a ...

As patients often see the data of their medical histories scattered among various medical records hosted in several health-care establishments, the purpose of our multidisciplinary study was to define a pragmatic and secure on-demand based system able to gather this information, with no risk of breaching confidentiality, and to relay ...