Adherence to a prescribed medication regimen is influenced not only by characteristics of the individual patient, but also by factors within the patient's environment, or so-called system level factors. Until now, however, health care system factors have received relatively little attention in explaining medication nonadherence. Ecological models might serve as ...

Medical Education 2012: 46 : 163-171 Context  Medical schools continue to seek robust ways to select students with the greatest aptitude for medical education, training and practice. Tests of general cognition are used in combination with markers of prior academic achievement and other tools, although their predictive validity is unknown. ...

: Treatment of sex partners is a core strategy for the control of chlamydia. Innovations such as patient-delivered partner therapy (PDPT) are effective in preventing repeat chlamydial infections, but providers' practice and perceptions of PDPT have not been adequately evaluated. This evaluation describes family planning providers' practices, knowledge, attitudes, and ...

Objective:  Evidence indicates that medical graduates with a rural background are more likely to become rural doctors than those with an urban background (the rural background effect (RBE)). Exactly why this is so has rarely been studied. This study sought to identify the role of social, environmental and economic factors ...

Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of ...

BACKGROUND:Although the discontinuation of a medication may have important clinical consequences, there is generally much less attention given to medication surveillance when a drug is stopped than when it is started.OBJECTIVE:To investigate the consequences on serum potassium levels of discontinuing a drug that increases the serum potassium level (PID↑) and ...

BACKGROUND: Poor adherence explains poor blood pressure (BP) control; however African Americans suffer worse hypertension-related outcomes. METHODS: This randomized controlled trial evaluated whether a patient education intervention enhanced with positive-affect induction and self-affirmation (PA) was more effective than patient education (PE) alone in improving medication adherence and BP reduction among ...

ABSTRACT: BACKGROUND: The current educational environment may need enhancement to tackle the rising cancer burden in India. The aim of this study was to conduct a survey of Surgical Oncologists to identify their perceptions of the current state of Oncology education in India. METHODS: An Institutional Review Board approved questionnaire ...

Glycosylation is highly variable depending on many environmental factors. Using our fully quantitative high-throughput normal phase hydrophilic interaction liquid chromatography we have identified glycosylation changes associated with medication in the plasma <i>N</i>-glycome from three different population cohorts: ORCADES from the Orkney Islands in Scotland and CROATIA-Vis and CROATIA-Korcula from the ...

BACKGROUND: Poor medication adherence (PMA) is associated with higher risks of morbidity, hospitalization, and mortality. Polypharmacy is not only a determinant of PMA but is also associated with many adverse health outcomes. OBJECTIVE: We aimed to determine the prevalence and correlates of PMA in an older population with polypharmacy. METHODS: ...

AIMS: To analyse predictors of glycaemic control including medication adherence and body mass index (BMI) in UK general practice patients with sub-optimally controlled type 2 diabetes. METHODS: Baseline demographic, health- and treatment-related measures were evaluated as predictors of one year glycaemic control defined separately as HbA(1c)≤7.5% and a continuous measure ...

OBJECTIVES:Approximately 4% to 12% of pregnant women have asthma; few studies have examined the effects of maternal asthma medication use on birth defects. We examined whether maternal asthma medication use during early pregnancy increased the risk of selected birth defects.METHODS:National Birth Defects Prevention Study data for 2853 infants with 1 ...

Abstract -  Aim:  To evaluate the influence of calcium hydroxide (CH) paste used as intracanal medication on the bond strength of AH Plus (AH) and Epiphany (EP) sealers to root dentin. Methodology:  Sixty palatal canals were prepared in human maxillary first molars, using a rotary system. Half of the specimens received ...

Abstract Background: Previous studies have shown that minority populations have low rates of documented advance directives and express preferences for more life-prolonging interventions at the end of life. We sought to determine the impact of Latino ethnicity on patients' self-report of having an advance directive discussion and having a completed ...

Aim:  To compare Beers' criteria (BC) and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) for prevalence, specificity, sensitivity and predictors for potentially inappropriate medication (PIM) use. Methods:  Patients aged ≥60 years from medicine wards of a tertiary care hospital were included. Comparisons between BC and STOPP were made using ...

OBJECTIVETo assess the individual financial impact of having diabetes in developing countries, whether diabetic individuals possess appropriate medications, and the extent to which health insurance may protect diabetic individuals by increasing medication possession or decreasing the risk of catastrophic spending.RESEARCH DESIGN AND METHODSUsing 2002-2003 World Health Survey data (n = ...

Abstract Objectives: Determine the use and utility of the Physician Orders for Life-Sustaining Treatment (POLST) program in a community where powers of attorney for health care (POAHCs) are prevalent. Methods: A retrospective review of medical record and death certificate data of 400 adults who died between September 1, 2007, and ...

Background. Increasing socio-economic inequalities in health, within a country as well as internationally, give rise to a timely question: Are there any systematic differences between people from differing social backgrounds with regard to their attitude to seeking professional medical assistance when experiencing physical problems of varying kinds? Material and method. ...

ACADEMIC EMERGENCY MEDICINE 2012; 19:1-6 © 2012 by the Society for Academic Emergency Medicine ABSTRACT: Objectives:  The objectives were to identify the social and medical factors associated with emergency department (ED) frequent use and to determine if frequent users were more likely to have a combination of these factors in ...

BACKGROUND: Women who experience unexpected labour and birth interventions describe feeling distressed and have an increased risk of postnatal depression. Primigravidae who have an unrealistic expectation of labour and birth may be at higher risk of these outcomes. AIMS: To determine whether primigravidae and their carers have a realistic expectation ...

BACKGROUND:: The pediatric medical home is an approach to the delivery of family-centered health care. Policy-makers and payers are interested in potential changes to health care utilization and expenditures under this model. OBJECTIVE:: To test associations between having a medical home and health service use and expenditures among US children ...

The aim of this study was to characterize cumulative exposure to ionizing radiation from diagnostic imaging (CEDI) in adult patients and investigate its relationship to a patient's socioeconomic status and comorbid medical conditions. A retrospective cohort study was conducted of 54,015 patients seen within the outpatient clinic system of an ...

This study analyzed recent trends in spending on psychiatric prescription drugs and underlying factors that served as drivers of these changes. Data were collected from the MarketScan Commercial Claims and Encounters Database (1997-2008), Substance Abuse and Mental Health Services Administration spending estimates (1986-2005), and the Medical Expenditure Panel Survey (1997-2007). ...

To present the planning and medical encounters for the 2010 Paralympic Winter Games. Prospective medical encounter study. 2010 Paralympic Winter Games. Athletes, coaches, officials, workforce, volunteers, and media. Sport type: alpine, Nordic, and sledge hockey and curling. Participant type: athlete, workforce, and spectators. Terrain and speed. Medical encounters entered in ...

This study aims to determine the impact of the geriatric consultation on the number of medications in hospitalized older adults and the corresponding financial impact. Retrospective chart review of patients seen by geriatric consultants. Tertiary-care teaching hospital. The number of medications prescribed before hospitalization, at time of consult, and at ...

With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, widespread adoption of certain health information technologies, such as electronic health records (EHRs) and electronic prescribing (e-prescribing), is imminent. Drug-drug interaction (DDI) screening and medication history information are commonly incorporated into health information exchange systems ...

The Society of Teachers of Family Medicine (STFM; http://www.stfm.org ) is a community of professionals devoted to teaching family medicine through undergraduate, graduate, and continuing medical education. This multidisciplinary group of physicians, educators, behavioral scientists, and researchers works to further STFM's mission of improving the health of all people through ...

Objective To assess the impact of medication reconciliation interventions on medication error rates when elderly patients are discharged from hospital to community care or nursing homes.Setting Elderly patients (>65 years) living in nursing homes or in their own homes with care provided by the community nursing system. Method All medical records ...

BACKGROUND: Inpatient stroke utilization may be decreasing over time and may vary by patient demographics. Less is known about temporal trends and demographic variations in outpatient stroke utilization. We assessed ischemic stroke (IS)-related outpatient utilization across physician specialty and time, exploring any demographic variability, using recent US population-based data. METHODS: ...

Although the frequency of self-medication among Mexican migrants has been well-documented in the public health literature, the multiple reasons for this practice are poorly understood. Most studies point to migrants' cultural preferences for Mexican medications, their prior experiences in countries where antibiotics are loosely regulated, and their lack of access ...

BACKGROUND AND PURPOSE: Patients discovered to have a patent foramen ovale in the setting of a cryptogenic stroke may be treated with percutaneous closure, antiplatelet therapy, or anticoagulants. A recent randomized trial (CLOSURE I) did not detect any benefit of closure over medical treatment alone; the optimal medical therapy is ...

Adherence to a medication regimen can be challenging for children and adolescents with mental health disorders. Medication education can be a beneficial tool for nurses to help promote adherence to psychotropic medications. This article describes an initiative to improve medication education offered to children and adolescents and their families on ...

PURPOSE: The purpose of this article is to consolidate some of the key concepts about scholarship in education related to the specialty of anesthesiology. We frame the discussion on two paradigm shifts in medical education, i.e., competency-based education and lifelong learning, and the scholarly approaches to lead these paradigm shifts ...

Tuberculosis (TB) is an infectious disease that declined significantly throughout the 20(th) century. Large-scale TB screening of entire populations in France and Germany has thus been replaced by active screening of risk-groups, particularly migrants. The article engages with its problems and practices on three levels: by looking at the way ...

ABSTRACT: BACKGROUND: Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. METHODS: A prospective study was ...

Financial relationships among the biomedical industries, physicians, and professional medical associations (PMAs) can be professional, ethical, mutually beneficial, and, most importantly, can lead to improved medical care. However, such relationships, by their very nature, present conflicts of interest (COIs). One of the greatest concerns regarding COI is continuing medical education ...

OBJECTIVE: To test associations between having a medical home and health services use and expenditures among US children with special health care needs (CSHCN). DESIGN: Cross-sectional analysis. SETTING: The 2003-2008 Medical Expenditure Panel Surveys. PARTICIPANTS: A total of 9816 CSHCN up to 17 years, including 1056 with a functional or ...

Background Appropriate prescribing is fundamental to successful pharmacotherapy. The status of current ambulatory medication practices in medicine and pharmacy would be better understood through an analysis of community pharmacy prescription claims. Objective The aims of the study were to investigate patterns of the types of prescriptions claimed by community pharmacies, ...

ObjectiveTo describe the creation and evaluate the use of a wiki by medical residents, and to determine if a wiki would be a useful tool for improving the experience, efficiency, and education of housestaff.Materials and methodsIn 2008, a team of medical residents built a wiki containing institutional knowledge and reference ...

Objectives:  To determine the extent, purpose, determinants and the impact of the utilization of Internet medical databases among the respondents. Methodology:  A descriptive cross sectional survey of 540 randomly selected physicians at the two tertiary health institutions in Osun State, South west, Nigeria. Result:  A total of 444 (82.2%) physicians ...

Among 320 patients with lower extremity peripheral artery disease (PAD) and low-density lipoprotein-cholesterol (LDL-C) levels > 70 mg/dl, we determined whether male sex, higher education, and greater self-efficacy for willingness to request therapy from one's physician were associated with increases in LDL-C-lowering medication and achievement of an LDL-C level < ...

Recent studies indicate that the number of first-year residency positions must increase to meet the United States' projected need for physicians, but these studies rarely consider whether it will be possible to increase the country's graduate medical education system to meet the need. State-level studies suggest that most existing programs ...

We aim to evaluate studies dealing with the incorporation of spirituality in medical education and to list the most scientific productive countries in this field. A bibliographical review was carried out. The final sample comprised 38 articles, which were divided into sub-topics for a clearer description. From these articles, 31 ...

Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about stone-forming ...

In airway management, poor judgment, education and training are leading causes of patient morbidity and mortality. The traditional model of medical education, which relies on experiential learning in the clinical environment, is inconsistent and often inadequate. Curriculum change is underway in many medical organisations in an effort to correct these ...

More than one in five Americans were in families reporting problems paying medical bills in 2010--about the same proportion as in 2007, according to a new national study by the Center for Studying Health System Change (HSC). Given the severe 2007-09 recession, the sluggish economic recovery and health care costs ...

Background: In the last decades there has been a sharp rise in the elderly population throughout the world. The unique needs of the elderly require a multidisciplinary and comprehensive medical approach. None of the 50 medical schools in Pakistan teach geriatrics in their undergraduate or postgraduate training. This paper discusses ...

Reasons for the rising annual incidence of esophageal adenocarcinoma (EAC) remain uncertain. Previous studies have given conflicting results, but some have suggested that drugs which relax the lower esophageal sphincter (LES) may increase the risk of EAC. This study is to determine systematically the risk of EAC associated with individual ...

Objective:To describe the implementation of a system-wide, electronic medical record (EMR)-based quality improvement intervention targeting medication reconciliation (MedRec) in outpatient pediatrics and to test variables associated with the performance of MedRec.Methods:This was a retrospective study using serial cross-sections of outpatient pediatric visits over a 5-year period set in a multispecialty ...

OBJECTIVES: To estimate the prevalence of using potentially inadequate drugs in the elderly population admitted to the Nuestra Señora de Sonsoles Hospital in Ávila according to Beers criteria, and to describe the impacts on these prescriptions following an educational seminar for prescribers. METHOD: Before and after observational study, with two ...