Implementing Culinary Medicine Training: Collaboratively Learning the Way Forward.

There is a documented substantial gap between the level of nutrition education for medical trainees and the need to provide nutrition counseling. Culinary medicine offers a solution, but there are multiple barriers and no guides to implementation. This article identifies core components and strategies to overcome barriers on the basis of experiences of multiple institutions.

Effect of a weight management program on the determinants and prevalence of metabolic syndrome.

Objective: As prevalence of obesity and metabolic syndrome (met synd) rises, establishing effective, community-based treatments is imperative. Our investigation sought to evaluate and report the effect of a weight management program on the prevalence and determinants of met synd, and the effect of participation level.

Methods And Procedures: Between 10 July 2001 and 17 November 2005, 339 of 574 individuals enrolled in and completed our 6-month weight management program at the McConnell Heart Health Center in Columbus, Ohio.

Randomized, double-blind, placebo-controlled trial of vaginal misoprostol for management of early pregnancy failures.

Objective: To determine whether misoprostol medical management of early pregnancy failures is more effective than expectant management.

Study Design: Patients diagnosed with early pregnancy failures, closed cervix, and minimal vaginal bleeding were randomized to 800 microg of misoprostol or placebo placed vaginally. Patients were evaluated by ultrasound imaging 24 hours and 48 hours after study drug administration, with repeat administration if 24-hour imaging showed a persistent gestational sac.

Interdisciplinary collaboration: the heart and soul of health care.

In a health care system in which patient complexity, outcome indicators, and informed families are representative of current reality, an interdisciplinary approach to care is crucial to successful navigation of a patient's experience in the ICU. To guide practitioners toward favorable patient progression, a thorough understanding of interdisciplinary collaboration is necessary. This article focuses on definitions of, benefits of, and barriers to interdisciplinary collaboration and provides practical solutions for implementation.

Hormonal treatment of a recurrent granulosa cell tumor of the ovary: case report and review of the literature.

Background: Granulosa cell tumors of the ovary are rare, primarily treated surgically. In advanced or recurrent disease, data are inconclusive regarding the benefit of either primary or adjuvant chemotherapy. Hormonal therapy has been suggested as an alternative treatment.

The caregiver's careshop. A renewal experience for nursing staff.

What are some creative methodologies that staff development educators can use to nurture nursing staff while promoting caring and compassionate behaviors? The authors describe an innovative process used during a 1-day workshop designed to convey caring to nursing staff through a variety of experiences. The overall goal of the session is to provide caregivers with a variety of new "tools" to care for themselves as they deal with multiple stressors in their personal and professional lives.

Health-related research among Amish women: a review of findings.

The objective of this literature review is to explore and synthesize research related to Amish women's health issues. Literature searches were conducted on an extensive list of Internet-based databases, with a total of 767 articles identified. Inclusion criteria consisted of published, gender-based, and evidence-based research.

Selection of obstetrics and gynecology residents on the basis of medical school performance.

Objective: The purpose of this study was to determine whether United States Medical Licensing Examination scores during medical school predict resident-in-training examination scores and whether other criteria of medical student performance correlate with the faculty's subjective evaluation of resident performance.

Study Design: United States Medical Licensing Examination step I and II scores for 24 residents were compared to their scores on in-training examinations. Faculty evaluated 20 graduated residents by rating both their cognitive and noncognitive clinical performance.

Policies on documentation and disciplinary action in hospital pharmacies after a medication error.

Hospital pharmacies were surveyed about policies on medication error documentation and actions taken against pharmacists involved in an error. The survey was mailed to 500 randomly selected hospital pharmacy directors in the United States. Data were collected on the existence of medication error reporting policies, what types of errors were documented and how, and hospital demographics.

H reflex and F wave latencies to soleus normal values and side-to-side differences.

Objective: Electromyographers must reliably differentiate between H reflexes and F waves when recording from the soleus muscle in the evaluation of S1 radiculopathy. The use of F waves in root-level injuries is questioned, whereas H reflexes have shown value in the evaluation of S1 radiculopathy. We studied the relationship between the tibial H reflex and F wave latencies in the limbs of 40 subjects.

Dietary restrictions for patients with neutropenia: a survey of institutional practices.

Purpose/objectives: To describe institutional practices related to dietary restrictions for patients with neutropenia to determine whether restrictions are used and when they are implemented and discontinued.

Design: Descriptive survey.

Sample: 156 institutions belonging to the Association of Community Cancer Centers.

Modification of port-access coronary artery bypass in high-risk patients.

Background: Minimally invasive port-access coronary artery bypass surgery has many potential advantages over routine median sternotomy coronary revascularization in patients with serious co-morbid conditions. The common femoral artery and vein have been the standard peripheral cannulation and balloon deployment sites. However, these sites present some risk, especially from proximal arteriosclerotic or aneurysmal disease.

The clinical and financial impact of port-access coronary revascularization.

Objective: Port-access coronary bypass grafting (CABG)was performed in an attempt to impact the clinical course of patients with coronary artery disease.

Methods: One hundred patients (56 men and 44 women) with a median age of 61 years underwent port-access coronary revascularization. The clinical and financial profiles of these patients were compared with fiscal year 1997 patients (n = 531) who underwent standard median sternotomy coronary bypass.

Anoxic-hypotensive brain injury: neuropsychological performance at 1 month as an indicator of recovery.

Design: This case control study included assessments at 3 and 8 weeks post brain injury. Controls were the non-brain injured subjects whose normative data has been published for neuropsychological measures. Data and medical information were obtained with informed consent.

Epoetin alfa: focus on inflammation and infection. Case study of the anemic patient.

Infectious and inflammatory disorders cause a disturbance in iron metabolism that leads to a sequestration of iron in the reticuloendothelial (R-E) system and a sometimes sharp and sudden decline in red blood cell indices. Underlying inflammatory conditions can decrease responsiveness to Epoetin alfa in dialysis patients and complicate anemia management. Understanding the possible infectious and inflammatory etiologies that can affect enemia management is essential to enhancing the nursing care of dialysis patients.

Asset management in theory and practice.

Managing capital-intensive imaging environments continues to be a challenge for nearly all administrators. Asset management, the strategic management of equipment inventory, must include planning, assessment, procurement, utilization review, maintenance, repair and disposal of equipment to reduce costs and improve efficiency. It must involve some shared risk between the facility and the provider, whether an original equipment manufacturer (OEM) or independent service organization (ISO).

Evolution of a cardiovascular information system.

The competitive nature of our evolving health care system mandates a concomitant increase in the level of sophistication of the cardiovascular information system. The new paradigms in health care also mandate a re-engineering of the process of data collection and analysis. This paper deals with a variety of hardware, software, and human issues encountered at our institution.

Relationship of nonstaging pathological risk factors to lymph node metastasis and recurrence in clinical stage I endometrial carcinoma.

Objective: To determine if DNA ploidy, hormone receptors, vascular space invasion (VSI), perivascular lymphocytes (PVL), and the oncogenes HER-2/neu, p53, and bcl-2 are independent prognostic indicators for lymph node metastasis and cancer recurrence in clinical stage I endometrial carcinoma.

Methods: Among 349 patients with clinical stage I endometrial cancer 31 patients either had lymph node metastases when surgically staged or developed recurrent cancer. Using a case-control matched-pair technique, controls were selected for each of 24 cases by matching for age, histological grade, depth of myometrial invasion, performance of node dissection, and use of adjuvant radiation therapy.

Single hospital experience with emergency cardiopulmonary bypass using the portable CPS (Bard) system.

One hundred four patients were placed emergently on the Bard CPS portable femoro-femoral bypass system over a 4 year period. Thirty-two patients (31%) were discharged from the hospital. Seventy-six of these patients (73%) required emergency bypass following cardiac arrest, and twenty-eight patients (26%) were in cardiogenic shock or respiratory failure.

Quality and liability issues with the Papanicolaou smear: lessons from the science of error prevention.

The pathologists and cytologists who study Papanicolaou smears perform a highly successful cancer screening test in a low-prevalence population. This leads to a mathematically inevitable false-negative error rate even in the most competent professional hands. The US judicial system supports a public expectation of perfect performance by civil and, recently, criminal punishment of error.