Group items tagged

"WHAT TO DO WHEN A PATIENT LACKS CAPACITY - The degree and urgency with which to act on findings of impaired capacity depends on multiple factors, including the expected duration of impairment, the severity of the impairment, and the seriousness of the decision. Unless the urgency of a patient's medical condition requires that a substituted decision be made immediately, efforts should be made to identify and correct any reversible causes of the impairment [26]. This is particularly relevant in hospitalized patients with impaired capacity due to delirium. Treatment of the underlying causes of delirium may restore decision-making capacity. Patients with mild to moderate cognitive impairment that is not expected to fluctuate may benefit from more intensive efforts at education to improve understanding of the relevant facts, followed by reassessment of decision-making abilities. A randomized trial found that a memory and organizational aid given to patients with mild stage Alzheimer disease dementia (n = 80) improved performance on understanding, which in turn increased the likelihood of being judged capable of providing informed consent to enroll in a clinical trial [34]. This enhancement was also effective in a randomized trial with middle-aged and older adults with schizophrenia [35]. For patients whose impairments are severe enough that they are judged to lack the capacity to make a decision, there is a clear ethical obligation to seek out a substitute decision maker. Substitute or surrogate decision makers should ideally have been chosen by the patient in advance. In the absence of a designated surrogate, laws may vary in terms of which people can serve in this proxy role and their hierarchy; in general, the order is the spouse, adult children, parents, siblings, and other relatives. (See "Legal aspects in palliative and end of life care", section on 'Surrogate decision makers'.) When making a substituted decision, the proxy should take into consideration

"The Generalists in Medical Education welcome basic scientists, clinicians, and other educators interested in medical education. We are educators who teach, conduct research, and provide support services in all areas of predoctoral, postdoctoral and continuing medical education. Specific areas of interest include curriculum and faculty development, testing and evaluation, and student services."

"Diagnostic accuracy was moderately associated with higher certainty only when clinical data were consistent. This correlation disappeared when incon sistent data were provided, possi bly reflecting changes in reasoning strategies among diagnostically success ful trainees. The relationship between certainty and diagnostic accuracy is context dependent. Certainty is an unreliable surrogate for diagnostic accuracy."

"The editors at iMedicalApps have gone through the free medical apps available for the iPad, and we have chosen 10 free medical apps that healthcare professionals can utilize. These apps range from simple drug reference apps to 3D virtual reality medical apps that make use of the iPads accelerometer. Unlike many other so called "top-10″ lists, this list is not based on the most downloaded apps in the medical section of the App Store."

"CPR game allows an individual to practice a simulated cardiac arrest scenario on an iPhone. The game is won by completing all "critical actions" in a timely manner and avoiding any harmful actions."

To educate public health professionals on the importance of health literacy and their role in providing health information and services and promoting public health literacy.

"During the 2-year period, 4282 patients were registered for the service. Patients made 2531 online visits, and billings were made for 1159 patients. E-visits were submitted primarily by women during working hours and involved 294 different conditions. Of the 2531 e-visits, 62 (2%) included uploaded photographs, and 411 (16%) replaced nonbillable telephone protocols with billable encounters. The e-visits made office visits unnecessary in 1012 cases (40%); in 324 cases (13%), the patient was asked to schedule an appointment for a face-to-face encounter. "

open source web conferencing tool

Communication cases

"I think it is safe to say that no physician is optimistic about the future of medicine at this point," one participant wrote. Others seemed downright hopeless...the practice of medicine continually gets worse and worse, more intolerable, more onerous, with absolutely no hope or reason for any optimism either in the near or remote future."

While More Americans Need Access to Essential Healthcare, Fewer Primary Care Clinicians Are Available to Treat Them. UVA Professor Says Increased Funding for Title VII Programs May Help Alleviate National Shortage of Primary Care Doctors and Dentists