Academic literature on the topic 'Colorado. University. General Medical Clinic'

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Journal articles on the topic "Colorado. University. General Medical Clinic"

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Marin, A. Itzam, Helio Neves da Silva, Hongan Chen, Nihaal Mehta, Linh K. Nguyen, Jeffrey R. SooHoo, Jennifer E. Adams, and Jasleen K. Singh. "A Third-Year Medical School Ophthalmology Curriculum for a Longitudinal Integrated Clerkship Model." Journal of Academic Ophthalmology 14, no. 02 (July 2022): e209-e215. http://dx.doi.org/10.1055/s-0042-1756201.

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Abstract Background Longitudinal Integrated Clerkships (LICs) are innovative educational models that allow medical student continuity with patients, preceptors, colleagues, and health care systems. Given their benefits, the number of LICs continues to increase. We share a pilot model for an ophthalmology LIC curriculum at the University of Colorado School of Medicine targeted for students to see patients through transitions of care. Methods A needs assessment was performed including literature search, interviews with expert faculty, and a precurricular student questionnaire. Based on our findings, we developed a pilot two-part curriculum consisting of an introductory lecture and a half-day clinical experience designed to integrate patient eye care into the LIC model. At the end of the year, students completed a questionnaire assessing attitude, confidence, and knowledge. Precourse data were collected from students in the academic year (AY) 2018/2019 to aid with the needs assessment. Postcourse data were collected after completion of the curriculum from students in AY 2019/2020. Data from questionnaire were intended to improve our curricular experience. Results Our curriculum was piloted between the 2019 and 2020 AY. The completion rate of our curriculum was 100%. The questionnaire response rate was 90% in pre- and postcurricular groups (n=15/17 and n=9/10, respectively). Hundred percent of students from both groups responded that it is “very important”/“important” for all physicians to be able to identify when ophthalmology referral is indicated. After the intervention, there were significant differences in the rate of students responding that they were “confident” diagnosing acute angle-closure glaucoma (36 vs. 78%, p=0.04), treating a chemical burn (20 vs 67%, p=0.02), and diagnosing viral conjunctivitis (27 vs. 67%); 90% of students reported increased confidence in longitudinal care of patients in the eye clinic. Conclusions Medical students believe in the importance of ophthalmic education regardless of their specialty of choice. We present a pilot model to introduce ophthalmology within an LIC model. Future studies with a larger sample are needed to determine the impact of this model in terms of knowledge acquisition and relationship between curriculum and ophthalmology interest among students. Our curriculum can be adapted to other underrepresented specialties in the medical school curriculum and is easily exportable to other LICs.
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Bugubaeva, M. "Multidisciplinary University Virtual Clinic - DIMEDUS in Teaching Students of the International Medical Faculty of Osh State University." Virtual Technologies in Medicine, no. 3 (August 29, 2022): 165–66. http://dx.doi.org/10.46594/2687-0037_2022_3_1483.

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Mastering practical skills with the help of simulation technologies eliminates the risk to the life, health of the patient and the stress of the trainee, allows you to conduct classes according to individual programs, without taking into account the operating mode of the clinic, makes it possible to repeatedly practice the skill and bring the manipulation to automatism. The article shows the effectiveness of the use of a multidisciplinary university virtual clinic - Dimedus in practical classes in teaching clinical disciplines to foreign students of the international medical faculty of Osh State University.
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Svatko, L. G., V. I. Galochkin, and K. A. Alimetov. "LXX years of the Department of Otorhinolaryngology, Kazan Medical University." Kazan medical journal 76, no. 1 (January 15, 1995): 1–6. http://dx.doi.org/10.17816/kazmj79849.

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The beginning of the development of otorhinolaryngology in Kazan should be considered 1925 - the time of the opening of the otorhinolaryngological department and clinic at the Faculty of Medicine of Kazan University. Its creation was carried out by prof. V.K. Trutnev.
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Vande Griend, Joseph, Danielle R. Fixen, Cy W. Fixen, Jason Zupec, and Joseph J. Saseen. "Clinic-Level Population Health Intervention by PGY2 Ambulatory Care Pharmacy Residents to Optimize Medication Management in a Self-Insured Employer Health Plan Population." Journal of Pharmacy Practice 31, no. 1 (March 14, 2017): 52–57. http://dx.doi.org/10.1177/0897190017698057.

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Background: Postgraduate year 2 ambulatory care pharmacy residents (PGY2 residents) may be able to improve healthcare quality by providing clinical pharmacy services provided to self-insured employer health plan patients. The objectives of this study are to describe this care delivery in a family medicine clinic, and to identify patients most likely to benefit from the service. Methods: From October 1, 2014 till June 30, 2015, comprehensive medication review was completed by PGY2 residents for patients insured by CU Anthem at the University of Colorado Westminster Family Medicine. For patients with medication-related problems (MRPs), a note was sent to the provider before the patient visit. Patient characteristics were compared in those who received a clinical pharmacy note with those who did not. Results: Sixty-eight MRPs were identified in 39 notes; 40 (58.8%) recommendations were implemented. The following Clinical Pharmacy Priority (CP2) score criteria were identified more frequently in patients with MRPs: age ≥65 years, diagnosis of diabetes, hypertension, chronic obstructive pulmonary disease, cardiovascular disease, blood pressure ≥140/90, hemoglobin A1c >7.9%, and ≥6 items on the medication list. Conclusion: PGY2 residents identified and resolved numerous clinically relevant MRPs. Patient-specific criteria can be utilized to target self-insured employer health plan patients who are likely to have clinically relevant MRPs.
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Kamiandrouskaya, A. A., I. O. Pokhodenko-Chudakova, A. S. Lastovka, E. S. Yadchenko, V. V. Gorbachev, M. S. Kosova, A. A. Kabanava, and N. A. Averchankava. "STAY IN THE ULM UNIVERSITY CLINIC (GERMANY)." Vestnik of Vitebsk State Medical University 20, no. 2 (April 15, 2021): 109–15. http://dx.doi.org/10.22263/2312-4156.2021.2.109.

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In March 2020 I was in the Ulm University Clinic for 2 weeks. My internship course took place on the basis of the department of general and visceral surgery. The work in the clinic is structured in such a way that not only surgeons but also doctors of the adjoining specialties, trainees and students participate in the discussion of patients’ treatment. And at the morning conferences, a resuscitator, a radiologist and an endoscopist must always be present. The operating unit has all necessary equipment in sufficient quantity. Preoperative preparation is carried out by the anesthetic team in the preoperative room. A special role is given to the patient’s thermal isolation using special blankets, protection of the patient’s eyes with a patch, and perioperative antibiotic prophylaxis. In addition to the operating surgeon and two main assistants, the operating team obligatorily includes a student. Continuous training by senior surgeons of junior ones is practiced. Basic surgical instruments are represented with everything you need. In the postoperative period all drugs are charged into infusion machines at a daily dosage, which simplifies the work of paramedical personnel and also reduces the risk of catheter infection. When entering a medical university the competition is initially very high (more than 20 people per place). All doctors work in a unified team, there is no strict division into university chairs and clinic departments. Two weeks spent in the Ulm University Clinic have shaped my understanding of medical care and medical education in Germany, acquainted me with the specificity of the surgical service and the technical features of performing surgical interventions.
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Komarov, R. N., and N. A. Kuznetsov. "175 years of the Faculty Surgery Department and N.N. Burdenko Faculty Surgery Clinic of the I.M. Sechenov First Moscow State Medical University (Sechenov University)." Clinical Medicine (Russian Journal) 99, no. 9-10 (January 27, 2022): 576–82. http://dx.doi.org/10.30629/0023-2149-2021-99-9-10-576-582.

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In 1846, the faculty surgery clinic of the Medical Faculty of Moscow University was established. An important role in its formation and further development was played by prominent surgeons who managed this clinic at various times (F.I. Inozemtsev, V.A. Basov, N.V. Sklifosovsky, A.A. Bobrov, N.N. Burdenko etc.). The contribution of all mentioned before is covered in detail in this article.
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Hua, Natalie T., Chia-Ding Shih, and David Tran. "Medical and Economic Impact of a Free Student-Run Podiatric Medical Clinic." Journal of the American Podiatric Medical Association 105, no. 5 (September 1, 2015): 418–23. http://dx.doi.org/10.7547/13-022.

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Background Data from the free student-run podiatric medical clinic at Clínica Tepati at the University of California, Davis, were used to analyze medical and economic impacts on health-care delivery and to extrapolate the economic impact to the national level. Clínica Tepati also provides an excellent teaching environment and services to the uninsured Hispanic population in the Greater Sacramento area. Methods In this analysis, we retrospectively reviewed patient medical records for podiatric medical encounters during 15 clinic days between November 2010 and February 2012. The economic impact was evaluated by matching diagnoses and treatments with Medicare reimbursement rates using International Classification of Diseases codes, Current Procedural Terminology codes, and the prevailing Medicare reimbursement rates. Results Sixty-three podiatric medical patients made 101 visits during this period. Twenty patients returned to the clinic for at least one follow-up visit or for a new medical concern. Thirty-nine different diagnoses were identified, and treatments were provided for all 101 patient encounters/visits. Treatments were limited to those within the clinic's resources. This analysis estimates that $17,332.13 worth of services were rendered during this period. Conclusions These results suggest that the free student-run podiatric medical clinic at Clínica Tepati had a significant medical and economic impact on the delivery of health care at the regional level, and when extrapolated, nationally as well. These student-run clinics also play an important role in medical education settings.
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Nguyen, Tao Nhat Thi, Linh Thi Xuan Huynh, Nhi Thi Thuy Huynh, and Van Kim Thi Nguyen. "SURVEY OF DISEASE MODEL AT TRA VINH UNIVERSITY GENERAL CLINIC." Scientific Journal of Tra Vinh University 1, no. 31 (September 1, 2018): 58–64. http://dx.doi.org/10.35382/18594816.1.31.2018.8.

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The study is to identify disease model and relevant factors at the General Clinic of Tra Vinh University (GC-TVU). A crosssectional survey of 42.884 patients who underwent medical treatment at GC-TVU from August 2016 to August 2017. The results showed that non-infectious diseases accounted for 62,4%, two times higher than that of infectious diseases (30,9%) and more than 9 times as compared with the trauma group, accident, poisoning (6,8%). The high rate of mental illness included 21,1% mental disorders, 19.8% infections and parasites, and 15,8% circulatory disease. The most common diseases are high blood pressure 11,4%, muscle pain 6,4%, back pain 5,9%, diabetes mellitus 3,7% and gastric inflammation 3,2%. The disease structure is closely related to age, sex and areaof living. This result is the basis for investing infrastructure and faculties and training of human resources in order to meet people’s needs and to improve the quality of health care routes.
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Editorial, E. "Erratum: The article „Congenital upper eyelid coboloma with ipsilateral eyebrow hypoplasia” [Urodjeni defekt gornjeg kapka sa istostranom hipoplazijom obrve]. Vojnosanit pregl 2012; 69(9): 809-811. (DOI:10.2298/VSP1209809V)." Vojnosanitetski pregled 73, no. 11 (2016): 1078. http://dx.doi.org/10.2298/vsp1611078e.

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The authors and their affiliations were listed as follows: Dejan Vulovic+, Marijan Novakovic??, Tatjana Sarenac?, Mirjana Janicijevic-Petrovic?, Nenad Petrovic?, Suncica Sreckovic?, Sasa Milicevic?, Branislav Piscevic? +Centre for Plastic Surgery, ?Clinic for Ophthalmology, Clinical Centre Kragujevac, Kragujevac, Serbia; ?Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia; ?Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia Listed the authors and their affiliations should read as: Dejan Vulovic+, Marijan Novakovic??, Tatjana Sarenac?, Mirjana Janicijevic-Petrovic?, Nenad Petrovic?, Suncica Sreckovic?, Sasa Milicevic?, Branislav Piscevic? +Centre for Plastic Surgery, ?Clinic for Ophthalmology, Clinical Centre Kragujevac, Kragujevac, Serbia; ?Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia; ?Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia <br><br><font color="red"><b> Link to the corrected article <u><a href="http://dx.doi.org/10.2298/VSP1209809V ">10.2298/VSP1209809V</a></b></u>
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McPoil, Thomas G. "Is Excellence in the Cards?" Physical Therapy 99, no. 10 (October 2019): 1281–90. http://dx.doi.org/10.1093/ptj/pzz104.

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ABSTRACT Thomas G. McPoil, PT, PhD, FAPTA, is Emeritus Professor of Physical Therapy at Regis University, Denver, Colorado, and Emeritus Regents’ Professor of Physical Therapy at Northern Arizona University. He has served as an Adjunct Honorary Professor in the School of Physiotherapy at the University of Queensland, Brisbane, Australia, and currently serves as a consultant to the Physical Therapy Orthotics Clinic at Denver Health Medical Center, Denver, Colorado. Dr. McPoil is known nationally and internationally for his scholarly contributions that have systematically examined foot and ankle function from both scientific and clinical perspectives. Dr. McPoil is an author or coauthor of 130 publications in peer-reviewed journals, coeditor of 2 books, and coauthor of 6 book chapters. His work reaches beyond the profession of physical therapy, as he served on the editorial boards of Foot and Ankle International, the Journal of Foot and Ankle Research, and Research in Sports Medicine and is currently on the editorial boards of the Journal of the American Podiatric Medical Association and The FOOT. Dr McPoil received his PhD in kinesiology with a specialization in biomechanics from University of Illinois at Urbana–Champaign. He holds an MS in physical education with a specialization in athletic training from Louisiana State University and a BA in physical education from the California State University, Sacramento. During his career, he has held faculty appointments at the University of Illinois at Chicago, Northern Arizona University, and Regis University. Dr McPoil’s clinical practice has focused on the management of chronic orthopedic foot and ankle disorders for the past 38 years. Dr McPoil is the founding president of the Foot and Ankle Special Interest Group of the Academy of Orthopaedic Physical Therapy. He has served as Vice President of the Academy of Orthopaedic Physical Therapy and as the Treasurer of the Journal of Orthopaedic and Sports Physical Therapy. He has received numerous teaching awards, including APTA’s Dorothy E. Baethke & Eleanor J. Carlin Award for Excellence in Academic Teaching and the Academy of Orthopaedic Physical Therapy’s James A. Gould Excellence in Teaching Orthopaedic Physical Therapy Award. He is a recipient of a Fulbright Senior Scholar Award, the William J. Stickel Award for Research in Podiatric Medicine, the Academy of Orthopaedic Physical Therapy’s Stanley Paris Distinguished Service Award and was elected a Catherine Worthingham Fellow of APTA in 2007.
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Dissertations / Theses on the topic "Colorado. University. General Medical Clinic"

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Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.

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Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.
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Books on the topic "Colorado. University. General Medical Clinic"

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E, Starzl Thomas. The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 1992.

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The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 1992.

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The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 2003.

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Teaching Comprehensive Medical Care: A Psychological Study of a Change in Medical Education. Harvard University Press, 2013.

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Teaching Comprehensive Medical Care: A Psychological Study of a Change in Medical Education. Harvard University Press, 1990.

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Brody, David L. Concussion Care Manual. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190054793.001.0001.

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This practical manual is for clinicians who care for patients with concussions. The effects of concussions are a recognized problem in the medical community and among the general public. Most people recover well from concussions, but a substantial minority does not. Most clinicians, however, do not have specific training in how to evaluate and treat concussion patients who do not make a rapid and complete recovery. This manual is based on the experience of the former director of the concussion clinic at Washington University in St. Louis, currently the director of the NIH/Uniformed Service University Traumatic Brain Injury Research Group. The manual provides step-by-step guidance for managing problems related to complex concussions: diagnosis, treatment strategies, headaches, sleep disruption, attention deficit, mood instability, anxiety and depression, post-traumatic stress, personality change, balance problems, dizziness, fatigue, and so forth. Specific sections address returning to work, driving, school, and contact sports. The manual also specifically addresses concussion in adolescents, children, elderly individuals, contact-sport athletes, military personnel, and patients involved in medico-legal matters. Finally, the manual discusses how to set up and run a concussion clinic. Clinicians with a broad range of backgrounds, including primary care physicians, nurse practitioners, physician’s assistants, athletic trainers, emergency medicine doctors, neurologists, neurosurgeons, psychiatrists, and rehabilitation medicine physicians should be able to use the manual effectively. Resident physicians and other trainees can use the manual without extensive background reading. Lists of Internet-based resources and other available publications direct the reader to information beyond what a pocket-sized manual can provide.
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Book chapters on the topic "Colorado. University. General Medical Clinic"

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Bonner, Thomas Neville. "Between Clinic and Laboratory: Students and Teaching at Midcentury." In Becoming a Physician. Oxford University Press, 1996. http://dx.doi.org/10.1093/oso/9780195062984.003.0012.

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Despite the gathering momentum for a single standard of medical education, the portals of access to medicine remained remarkably open at the middle of the nineteenth century. From this time forward, governments and professional associations—in the name of science and clinical knowledge and the protection of the public’s health—steadily limited further entrance to medicine to those with extensive preparatory education and the capacity to bear the financial and other burdens of ever longer periods of study. But in 1850, alternative (and cheaper) paths to medicine, such as training in a practical school or learning medicine with a preceptor, were still available in the transatlantic nations. Not only were the écoles secondaires (or écoles préparatoires) and the medical-surgical academies still widely open to those on the European continent without a university-preparatory education, but British and American training schools for general practitioners, offering schooling well below the university level, were also widely available to students and growing at a rapid pace. “The establishment of provincial medical schools,” for those of modest means, declared Joseph Jordan of Manchester in 1854, was an event “of national importance. . . . Indeed there has not been so great a movement [in Britain] since the College of Surgeons was established.” A decade before, probably unknown to Jordan, a New York professor, Martyn Paine, had voiced similar views about America’s rural colleges when he told students that “no institutions [are] more important than the country medical schools, since these are adapted to the means of a large class of students . . . [of] humble attainments.” In both Britain and America, according to Paine’s New York contemporary John Revere, the bulk of practitioners “are generally taken from the humbler conditions in society, and have few opportunities of intellectual improvement.” The social differences between those who followed the university and the practical routes to medicine were nearly as sharp as they had been a halfcentury before. Even when a medical degree was awarded after what was essentially a nonuniversity education, as it was in the United States, Paine distinguished between graduates of country schools, “where lectures and board are low,” and “the aristocrats of our profession, made so through the difference of a few dollars.”
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Conference papers on the topic "Colorado. University. General Medical Clinic"

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Rebegea, Laura, Camelia Tarlungianu, Rodica Anghel, Dorel Firescu, Nadejda Corobcean, and Laurentia Gales. "BURNOUT RISK EVALUATION IN MEDICAL ONCOLOGY – RADIOTHERAPY PERSONNEL." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.5.

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Europäische Wissenschaftliche Gesellschaft Home About the Journal Peer Review Editorial Board For Authors Reviewer Recognition Archiv Kontakt Impressum EWG e.V. indexing in the Clarivate Analytics indexing in the Emerging Sources Citation Index Crossref Member Badge Erfolgreich durch internationale Zusammenarbeit PUBLIC HEALTH DOI 10.35630/2022/12/psy.ro.5 Received 14 December 2022; Published 6 January 2023 BURNOUT RISK EVALUATION IN MEDICAL ONCOLOGY – RADIOTHERAPY PERSONNEL Laura Rebegea1,2 orcid id logo, Camelia Tarlungianu1 , Rodica Anghel3 orcid id logo , Dorel Firescu4,5, Nadejda Corobcean1,6, Laurentia Gales3 orcid id logo 1 Department of Medical Oncology - Radiotherapy, „Sf. Ap. Andrei” Emergency Clinical Hospital, Galati, Romania 2 Medical Clinical Department, Faculty of Medicine, „Dunarea de Jos” University of Galati, Romania 3 „Carol Davila” University of Medicine and Pharmacy”, Bucharest, Romania 4 IInd Clinic of Surgery, „Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania 5 Surgical Clinical Department, „Dunarea de Jos” University, Faculty of Medicine and Pharmacy, Galati, Romania 6 „Nicolae Testemitanu”State University of Medicine and Pharmacy. Chisinau, Moldova download article (pdf) laura_rebegea@yahoo.com, tarlungianucamelia@yahoo.com ABSTRACT Introduction: Even if, all studies evidenced that Burnout syndrome affects medical personnel from all medical specialties, the highest prevalence is in surgical, oncological and emergency medical specialties. Scope: Burnout syndrome evaluation in Medical Oncology and Radiotherapy personnel. Method and material: This study has involved 50 persons employee in Medical Oncology and Radiotherapy Department, from all categories: 11 superiors personal (medical doctors, physicists, psychologist), 31 nurses, and 8 auxiliary personnel (stretcher-bearer). The following questionnaires were used: professional exhaustion level questionnaire (with 25 items), questionnaire for attitude and adaptation in stressed and difficulties situations, BRIEF COPE and SES scale. Results: After professional exhaustion level questionnaire for superior personnel, emotional exhaustion prevalence, followed by reduced personal achievement and an accentuated increasing of affecting grade after first year of activity, with a pick around 10 years of activity were revealed. For nurses, share of depersonalization is relative homogenous, in moderate - low limits. The results revealed that 56% of personnel from this study have risk for burnout syndrome developing, without any prevention methods and 12% has already burnout syndrome. Conclusions: In general, this syndrome is under-evaluated and under-diagnosed, and its incidence can be diminishing by using the techniques of stress resistance, psychological counseling, cresting a friendly and tolerant professional climate.
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Reports on the topic "Colorado. University. General Medical Clinic"

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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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