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anonymous

Self-Other Agreement in Multisource Feedback: The Influence of Doctor and Rater Group C... - 0 views

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    "Self-other agreement in MSF ratings is influenced by characteristics of both raters and ratees. Managers, appraisers, and others responsible for interpreting and reviewing feedback results with the doctor need to be aware of these influences."
anonymous

Cardiio Launches innovative iPhone App for touch-free heart rate monitoring - 0 views

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    "While its not clear how popular regularly measuring ones heart rate will be in the general population, this certainly will be a tool eagerly taken up by self quantifiers. I am most excited about the utility of this for passive, no touch monitoring in health care settings as the technology advances to not require the camera so perfectly aligned and close to the face."
anonymous

Commentary: A Sense of Story, or Why Teach Reflective Writin... : Academic Medicine - 3 views

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    "The duty of the teacher in this model is not to judge and rate but, rather, to read and tell what is seen. Our teachers, having been trained in the acts of close reading, are equipped not with rating rubrics but, rather, with a reading guide that prompts the reader to attend to several narrative features of a text. The reader/coach can thereby first see and then show the writer what is contained in the written text, at least from that reader's vantage point, helping along the process not only of the writing but also of the reflection the writing birthed. Multiple readers swell and complicate the lessons learned. As a dividend, we have observed, the group of readers/writers form strong, trusting, collaborative teams. And so our training for reflection also fulfills other difficult missions of medical education in teamwork, peer learning, trust, and care."
anonymous

From Mindless to Mindful Practice - Cognitive Bias and Clinical Decision Making - NEJM - 1 views

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    "The two major products of clinical decision making are diagnoses and treatment plans. If the first is correct, the second has a greater chance of being correct too. Surprisingly, we don't make correct diagnoses as often as we think: the diagnostic failure rate is estimated to be 10 to 15%. "
anonymous

The Clinical Assessment of Substance Use Disorders - publication - MedEdPORTAL - 0 views

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    "To describe the essential components of the medical model of substance use disorders. To delineate the interviewing skills necessary to screen effectively for substance use and abuse. To understand the high rate of psychiatric and medical co-morbidity and more effectively screen patients for these disorders. To demonstrate skills for evaluating patients' stage of change, readiness to accept the diagnosis, and readiness to undertake behavior change. To clearly and supportively recommend treatment to patients with substance use disorders. To describe the skills required for addiction prevention counseling. To define the skills that help set respectful limits on patient requests for prescription medication. To demonstrate awareness of how physician/clinician attitudes toward patients with substance use disorders impact recognition, diagnosis, and treatment of patients. To demonstrate knowledge of substance use disorder treatment standards and the ability to recommend appropriate referrals."
anonymous

The 360-degree Assessment: A New Paradigm in Trainee Evaluation - 0 views

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    The 360-degree assessment is a new paradigm in medical evaluation in which a trainee is evaluated by multiple people in his or her sphere of influence. Evaluators measure identical parameters using the same rating scale, with an additional subset of uniquely designed items to capture areas particular to certain groups.
anonymous

The view from over there: reframing the OSCE through the experience of standardised pat... - 1 views

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    "The results can be used to reframe understanding of the SP role and of the psychometric discourse of assessment. Ratings awarded by SPs are socially constructed and reveal the complexity of the OSCE process and the unfeasibility of absolute objectivity or standardisation. Standardised patients valued individuality, subjective experience and assessment for learning. The potential of SPs is under-used their greater involvement should be used to promote real partnership as educators move into a post-psychometric era. New-generation assessments should strive to value subjective experience as well as psychometric data in order to utilise the significant potential for learning within assessment."
anonymous

The delivery of public health interventions online - 0 views

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    The Internet increasingly serves as a platform for the delivery of public health interventions. The efficacy of Internet interventions has been demonstrated across a wide range of conditions. Much more work remains, however, to enhance the potential for broad population dissemination of Internet interventions. In this article, we examine the effectiveness of Internet interventions, with particular attention to their dissemination potential. We discuss several considerations (characterizing reach rates, minimizing attrition, promoting Web site utilization, use of tailored messaging and social networking) that may improve the implementation of Internet interventions and their associated outcomes. We review factors that may influence the adoption of Internet interventions in a range of potential dissemination settings. Finally, we present several recommendations for future research that highlight the potential importance of better understanding intervention reach, developing consensus regarding Web site usage metrics, and more broadly integrating Web 2.0 functionality.
anonymous

Faculty Of 1000 Medicine - 0 views

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    Faculty of 1000 Medicine is a unique online service that helps you stay informed of high impact articles and access the opinions of global leaders in medicine. Its distinguished faculty of over 2400 of the world's top clinicians and researchers select, rate and evaluate the most important and influential articles, presenting a continuously updated, authoritative guide to the medical literature that matters
anonymous

Portfolio Assessment - 0 views

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    "In portfolio assessment, the face validity is high; the educational impact is positive in terms of directing student learning toward the curriculum outcomes; many medical schools find portfolio assessment to be feasible; acceptability grows with time and with suitable modifications; and reliability may be acceptable if one is prepared to sample through the sources of bias, make use of pre-validated rating rubrics, and train the assessors. Portfolio assessment has much to offer"
Dr.Ravichandra Karkal

AccessMedicine | Drug Absorption, Bioavailability, and Routes of Administration - 0 views

  • Subcutaneous
  • not irritating to tissue
  • Moreover, altering the period over which a drug is absorbed may be varied intentionally, as is accomplished with insulin for injection using particle size, protein complexation, and pH to provide short- (3 to 6 hours), intermediate- (10 to 18 hours), and long-acting (18 to 24 hours) preparations.
  • ...7 more annotations...
  • Intramuscular
  • Drugs in aqueous solution are absorbed quite rapidly after intramuscular injection depending on the rate of blood flow to the injection site.
  • may be modulated to some extent by local heating, massage, or exercise.
  • while absorption of insulin generally is more rapid from injection in the arm and abdominal wall than the thigh, jogging may cause a precipitous drop in blood sugar when insulin is injected into the thigh rather than into the arm or abdominal wall because running markedly increases blood flow to the leg.
  • A hot bath accelerates absorption from all these sites owing to vasodilation.
  • fat is relatively poorly perfused.
  • Slow, constant absorption from the intramuscular site results if the drug is injected in solution in oil or suspended in various other repository (depot) vehicles.
Ambika Kilaparthi

Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why. - 0 views

  • response to placebo was considered a psychological trait related to neurosis and gullibility rather than a physiological phenomenon that could be scrutinized in the lab and manipulated for therapeutic benefit. But then Benedetti came across a study, done years earlier, that suggested the placebo effect had a neurological foundation. US scientists had found that a drug called naloxone blocks the pain-relieving power of placebo treatments. The brain produces its own analgesic compounds called opioids, released under conditions of stress, and naloxone blocks the action of these natural painkillers and their synthetic analogs.
  • Placebo-activated opioids, for example, not only relieve pain; they also modulate heart rate and respiration. The neurotransmitter dopamine, when released by placebo treatment, helps improve motor function in Parkinson's patients. Mechanisms like these can elevate mood, sharpen cognitive ability, alleviate digestive disorders, relieve insomnia, and limit the secretion of stress-related hormones like insulin and cortisol.
  • Alzheimer's patients with impaired cognitive function get less pain relief from analgesic drugs than normal volunteers do. Using advanced methods of EEG analysis, he discovered that the connections between the patients' prefrontal lobes and their opioid systems had been damaged. Healthy volunteers feel the benefit of medication plus a placebo boost. Patients who are unable to formulate ideas about the future because of cortical deficits, however, feel only the effect of the drug itself. The experiment suggests that because Alzheimer's patients don't get the benefits of anticipating the treatment, they require higher doses of painkillers to experience normal levels of relief.
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  • placebo response has limits. It can ease the discomfort of chemotherapy, but it won't stop the growth of tumors. It also works in reverse to produce the placebo's evil twin, the nocebo effect. For example, men taking a commonly prescribed prostate drug who were informed that the medication may cause sexual dysfunction were twice as likely to become impotent.
  • placebo aids recovery is by hacking the mind's ability to predict the future. We are constantly parsing the reactions of those around us—such as the tone a doctor uses to deliver a diagnosis—to generate more-accurate estimations of our fate. One of the most powerful placebogenic triggers is watching someone else experience the benefits of an alleged drug. Researchers call these social aspects of medicine the therapeutic ritual.
  • What turns a dummy pill into a catalyst for relieving pain, anxiety, depression, sexual dysfunction, or the tremors of Parkinson's disease? The brain's own healing mechanisms, unleashed by the belief that a phony medication is the real thing. The most important ingredient in any placebo is the doctor's bedside manner, but according to research, the color of a tablet can boost the effectiveness even of genuine meds—or help convince a patient that a placebo is a potent remedy.
  • Red pills can give you a more stimulating kick
  • green reduces anxiety
  • White tablets—particularly those labeled "antacid"—are superior for soothing ulcers
  • More is better,scientists say. Placebos taken four times a day deliver greater
  • Branding matters. Placebos stamped or packaged with widely recognized trademarks are more effective than "generic"
  • Clever names
  • volunteers in this high-interaction group got as much relief as did people taking the two leading prescription drugs for IBS. And the benefits of their bogus treatment persisted for weeks afterward, contrary to the belief—widespread in the pharmaceutical industry—that the placebo response is short-lived.
  • hybrid treatment strategies that exploit the placebo effect to make real drugs safer and more effective. Cancer patients undergoing rounds of chemotherapy often suffer from debilitating nocebo effects—such as anticipatory nausea—conditioned by their past experiences with the drugs. A team of German researchers has shown that these associations can be unlearned through the administration of placebo, making chemo easier to bear.
  • body's response to certain types of medication is in constant flux, affected by expectations of treatment, conditioning, beliefs, and social cues.
  • Big Pharma have moved aggressively into Africa, India, China, and the former Soviet Union. In these places, however, cultural dynamics can boost the placebo response in other ways. Doctors in these countries are paid to fill up trial rosters quickly, which may motivate them to recruit patients with milder forms of illness that yield more readily to placebo treatment. Furthermore, a patient's hope of getting better and expectation of expert care—the primary placebo triggers in the brain—are particularly acute in societies where volunteers are clamoring to gain access to the most basic forms of medicine. "The quality of care that placebo patients get in trials is far superior to the best insurance you get in America
  • The HAM-D was created nearly 50 years ago based on a study of major depressive disorder in patients confined to asylums. Few trial volunteers now suffer from that level of illness. In fact, many experts are starting to wonder if what drug companies now call depression is even the same disease that the HAM-D was designed to diagnose.
  • What all of these disorders have in common, however, is that they engage the higher cortical centers that generate beliefs and expectations, interpret social cues, and anticipate rewards. So do chronic pain, sexual dysfunction, Parkinson's
  • In standard trials, the act of taking a pill or receiving an injection activates the placebo response. In open/hidden trials, drugs and placebos are given to some test subjects in the usual way and to others at random intervals through an IV line controlled by a concealed computer. Drugs that work only when the patient knows they're being administered are placebos themselves.
  • Ironically, Big Pharma's attempt to dominate the central nervous system has ended up revealing how powerful the brain really is. The placebo response doesn't care if the catalyst for healing is a triumph of pharmacology, a compassionate therapist, or a syringe of salt water. All it requires is a reasonable expectation of getting better. That's potent medicine.
avivajazz  jazzaviva

MedlineRanker: flexible ranking of biomedical literature - 0 views

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     MedlineRanker is free for use and is available at http://cbdm.mdc-berlin.de/tools/medlineranker.
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