A Smartphone Resource for Just-in-Time Medical Student Teaching by Emergency Medicine Residents.

Objectives Previous studies have shown that residents play an important role in the education of medical students in the clinical setting, but the busy environment of the emergency department (ED) poses a challenge to the effective teaching of medical students by emergency medicine (EM) residents. To combat this, this study relies on just-in-time teaching, which refers to the application of teaching efforts specific to a particular moment, in this case, a clinical case or procedure. Building on studies showing that just-in-time teaching can improve education despite time constraints, as well as data showing that practitioners and trainees increasingly use apps for diagnosis and education, the objective of this project was to determine whether a free open-access medical education (FOAM) smartphone application (app) is feasible and improves the quality and frequency of resident teaching of medical students in the emergency department.

Sequence Alterations of Cortical Genes Linked to Individual Connectivity of the Human Brain.

Individual differences in humans are driven by unique brain structural and functional profiles, presumably mediated in part through differential cortical gene expression. However, the relationships between cortical gene expression profiles and individual differences in large-scale neural network organization remain poorly understood. In this study, we aimed to investigate whether the magnitude of sequence alterations in regional cortical genes mapped onto brain areas with high degree of functional connectivity variability across individuals.

The Social Work Role in Reducing 30-Day Readmissions: The Effectiveness of the Bridge Model of Transitional Care.

The hospital experience is taxing and confusing for patients and their families, particularly those with limited economic and social resources. This complexity often leads to disengagement, poor adherence to the plan of care, and high readmission rates. Novel approaches to addressing the complexities of transitional care are emerging as possible solutions.

Achieving a high-performance health care system with universal access: what the United States can learn from other countries.

This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the American College of Physicians, this article takes a comprehensive approach to improving access, quality, and efficiency of care. The first part describes health care in the United States.

Racial and ethnic disparities in health care: a position paper of the American College of Physicians.

Disparities clearly exist in the health care of racial and ethnic minorities. This position paper of the American College of Physicians (ACP) provides ample evidence illustrating that minorities do not always receive the same quality of health care, do not have the same access to health care, are less represented in the health professions, and have poorer overall health status than nonminorities. The ACP finds this to be a major problem in our nation's health system that must be addressed.

The effect of tibolone on bone mineral density in postmenopausal women with osteopenia or osteoporosis--8 years follow-up.

Objectives: This longitudinal observational study evaluated the effect of 8 years of uninterrupted treatment of tibolone on bone mineral density (BMD) in postmenopausal women with significant osteopenia or osteoporosis.

Material And Methods: Subjects were 66 postmenopausal women (29 with moderate or severe osteopenia and 37 with osteoporosis) who took tibolone (2.5 mg nocte) uninterruptedly for over 8 years and who attended for annual BMD assessments.

Composite method to quantify powder flow as a screening method in early tablet or capsule formulation development.

The flow properties of typical tablet and capsule formulation excipients, active compounds, and representative formulation blends were tested with current and novel flow measurement techniques to identify a reliable bench test to quantify powder flow as a screening method in early tablet and capsule formulation development. Test methods employed were vibrating spatula, critical orifice, angle of repose, compressibility index, and avalanching analysis. Powder flow results from each method were compiled in a database, sorted, and compared.

A cross-sectional study of the effects of hormon replacement therapy on the cardiovascular disease risk profile in healthy postmenopausal women.

Objective: To assess risk factors for cardiovascular disease in healthy postmenopausal women who had been uninterruptedly on menopausal hormone replacement therapy (HRT) for at least 5 years or who had not received any HRT.

Design: Cross-sectional study.

Setting: The Royal Free Hospital and The Middlesex Hospital.

Physicians and joint negotiations.

This position paper of the American College of Physicians-American Society of Internal Medicine addresses public policy issues related to physicians' joining to negotiate issues affecting patient care and the working environment in which patient services are provided. It seeks to identify an appropriate way for physicians to negotiate jointly with health care plans while maintaining professionalism and keeping the interests of patients paramount. It proposes that physicians in nonintegrated private practices should be able to meet and communicate among themselves for the purpose of negotiating primarily with health care plans about specific issues that affect quality and access.

Effects of physical activity and menopausal hormone replacement therapy on postural stability in postmenopausal women--a cross-sectional study.

Objectives: Poor postural stability and muscular strength in postmenopausal women are associated with increased risk of falls and fractures. This study examined whether these risk factors for falls differed according to habitual physical activity and menopausal hormone replacement therapy (HRT) use.

Methods: Subjects were 117 postmenopausal women (mean age 65.

Unmet health needs of uninsured adults in the United States.

Context: In 1998, 33 million US adults aged 18 to 64 years lacked health insurance. Determining the unmet health needs of this population may aid efforts to improve access to care.

Objective: To compare nationally representative estimates of the unmet health needs of uninsured and insured adults, particularly among persons with major health risks.

The influence of physical activity on the response of bone mineral density to 5 years tibolone.

Objectives: Menopausal hormone replacement therapy (HRT) maintains bone mineral density (BMD) and reduces risk of fracture in postmenopausal women. It has been suggested that sex steroids and loading may have synergistic effects on bone. We therefore investigated whether habitual physical activity influences the response of BMD to tibolone in postmenopausal women.

Serum vascular endothelial growth factor concentrations in postmenopausal women: the effect of hormone replacement therapy.

Objective: To assess serum vascular endothelial growth factor (VEGF) concentrations in healthy postmenopausal women in relation to hormone replacement therapy (HRT) and the presence or absence of a uterus.

Design: Cross-sectional study.

Setting: The Middlesex Hospital.

Double-blind, placebo-controlled study of the effects of tibolone on bone mineral density in postmenopausal osteoporotic women with and without previous fractures.

A 2-year placebo-controlled, randomized, two-center prospective study was carried out to assess the effects of tibolone (Org OD14, Livial) on trabecular and cortical bone mass and bone biochemistry parameters in elderly postmenopausal women with and without previous fractures. In total, 107 subjects, 71 with fractures and 36 without fractures, were randomized to tibolone (n = 64) or placebo (n = 43). Their mean age was 63.

Telemedicine applications in otolaryngology.

Under suitable technical and clinical conditions, remote interactive fiber-optic NPL can be used to evaluate a range of commonly occurring pathologies with a high degree of reliability. A clinical protocol appropriate for interactive and store-and-forward fiber-optic NPL was proposed for further evaluation. Additional applications of telemedicine in otolaryngology were outlined, including otoscopy, intra-oral examination, and evaluation of external facial pathology.

Teleconsultation in otolaryngology: live versus store and forward consultations.

Objective: To evaluate the relative strengths and weaknesses of interactive and delayed teleconsultations in otolaryngology.

Setting: Ambulatory clinic at an urban tertiary care facility.

Subjects: Forty-five adult patients with known or suspected upper aerodigestive tract pathology.