This paper provides a foundation for establishing curricula to train medical residents in ambulatory care. To do so, it first presents reasons that curricula are needed in this area. It then delineates attitudes and proficiencies (knowledge and skills) that such curricula should be designed to instill. Finally, it briefly discusses implications for curriculum development. Extensive tables are provided, including detailed lists of generic proficiencies that residents should attain. Among realms in which these proficiencies lie are organizing the ambulatory care encounter, using interpersonal skills, gathering information through physical examination and other means, obtaining and employing clinically useful knowledge, documenting the encounter, and planning and coordinating care. The paper notes that planning for the discharge of patients from the hospital can contribute to obtaining proficiencies important in ambulatory care.
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http://dx.doi.org/10.1007/BF02600433 | DOI Listing |
Commun Med (Lond)
January 2025
Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
Background: The ability to non-invasively measure left atrial pressure would facilitate the identification of patients at risk of pulmonary congestion and guide proactive heart failure care. Wearable cardiac monitors, which record single-lead electrocardiogram data, provide information that can be leveraged to infer left atrial pressures.
Methods: We developed a deep neural network using single-lead electrocardiogram data to determine when the left atrial pressure is elevated.
Sci Rep
January 2025
Division of Metabolic Disorders, CHOC Children's Hospital, Orange, CA, 92868, USA.
Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rapidly progressive neurodegenerative disorder leading to premature mortality. Ambulatory CLN2 patients typically receive standard of care treatment through biweekly intracerebroventricular (ICV) enzyme replacement therapy (ERT) involving recombinant human tripeptidyl peptidase 1, known as cerliponase alfa (Brineura, Biomarin Pharmaceuticals). This study longitudinally assessed the impact of ICV cerliponase alfa ERT on gait, and postural control across a two-year span in two siblings diagnosed with atypical CLN2 disease.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
Introduction: is a manualised self-management fall prevention programme co-developed for and with ambulatory and non-ambulatory people with multiple sclerosis (PwMS). Findings from a feasibility study indicate the necessity of a full-scale randomised controlled trial (RCT).
Methods And Analysis: A parallel-group RCT with a mixed methods process evaluation as well as a cost-effectiveness evaluation will be conducted.
PLoS One
January 2025
Department of Health Sciences, Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Objectives: Only studying effectiveness of lifestyle interventions for people with severe mental illness (SMI) is insufficient for policy making. As budgets for healthcare are limited, policy makers face the problem of allocating scarce healthcare resources. Cost-effectiveness studies are needed, but currently cost-effectiveness studies of lifestyle interventions for people with SMI delivered in ambulatory care are limited.
View Article and Find Full Text PDFArch Dermatol Res
January 2025
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Trends in outpatient dermatology appointment wait times for United States (US) veterans are poorly characterized. Given concerns surrounding prolonged wait times at Veterans Health Administration (VHA) medical facilities, the federal government introduced the Maintaining Internal Systems and Strengthening Outside Networks (MISSION) Act in 2018, allowing veterans to receive VHA-reimbursed community care if VHA specialty care appointments cannot be scheduled within 28 days. Considering this expanded access to community care, we characterized among US veterans the (1) overall demand for dermatology appointments, (2) trends in average wait times, and (3) facility/geographic variation in wait times.
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