Wisconsin Medical Journal最新文献_第10页

Getting SET for Student Success: Foundations for a Student Education Team. 为学生的成功做好准备:学生教育团队的基础。

Wisconsin Medical Journal Pub Date : 2022-12-01

Sarah M Strahm, Kimberly A Frodl, John Organick-Lee, Erica L Vogel, Stephanie M Raap, Justin Chilson, Mark E Deyo-Svendsen, Donn D Dexter, Terri Nordin

引用次数: 0

Use of Peer- and Self-Evaluation to Improve Conversations with Interfacility Referring Clinicians. 使用同伴和自我评价来改善与机构间转诊临床医生的对话。

Wisconsin Medical Journal Pub Date : 2022-12-01

Anika Nelson, Svetlana Melamed, Sarah Corey Bauer, Erin Preloger, Kelsey Porada, Jennifer Hadjiev

{"title":"Use of Peer- and Self-Evaluation to Improve Conversations with Interfacility Referring Clinicians.","authors":"Anika Nelson, Svetlana Melamed, Sarah Corey Bauer, Erin Preloger, Kelsey Porada, Jennifer Hadjiev","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Pediatric hospital medicine physicians receive little formal training in communicating with interfacility referring clinicians. We sought to improve pediatric hospital medicine physician confidence and communication scores by 10% during patient triage calls from interfacility referring providers via a continuing professional development initiative.Methods: We conducted a single-center 10-month quality improvement project. Confidence was assessed via survey before and after the initiative. A novel self- and peer-evaluation tool was used to assess accepting pediatric hospital medicine physician communication on recorded calls. Call assessment scores were measured at baseline, cycle 1, and cycle 2. Interventions included group discussion and development of a scripting flowsheet.Results: Twenty pediatric hospital medicine physicians participated and completed a total of 203 call assessments. From baseline to post-initiative, general confidence communicating with referring clinicians increased by 13% (mean ranks 11.8, 16.8, respectively), and specific confidence communicating when there is a difference of opinion increased significantly by 37% (mean ranks 9.8, 19.2, P < 0.001). Interfacility transfer conversation evaluation scores increased by 11%.Discussion: Our initiative improved accepting physician's confidence and communication evaluation scores using self- and peer-evaluation, group reflection, and a scripting flowsheet. Self- and peer-evaluation of recorded calls can be an effective intervention for building physician confidence in communicating with referring clinicians.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10588990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Triad of Pericarditis, Pericardial Effusion, and Pleural Effusion as the Predominant Presentation of Rheumatoid Arthritis - A Case Report. 心包炎、心包积液、胸膜积液三联征为类风湿关节炎的主要表现- 1例报告。

Wisconsin Medical Journal Pub Date : 2022-12-01

Adam Devine, Michael Aljadah, Rebecca Weiner, Iryna Nemesh, Divyanshu Mohananey

引用次数: 0

Simulation-Based Medical Education: Development of an Assessment Tool for Novice Use. 基于模拟的医学教育:为新手使用的评估工具的开发。

Wisconsin Medical Journal Pub Date : 2022-12-01

Sasha M Ulrich, Joseph C L'Huillier, Sarah A Jung, Laura K Krecko, Alexandra A Rosser, Amy K Schulze, Amy E Liepert, Ann P O'Rourke

{"title":"Simulation-Based Medical Education: Development of an Assessment Tool for Novice Use.","authors":"Sasha M Ulrich, Joseph C L'Huillier, Sarah A Jung, Laura K Krecko, Alexandra A Rosser, Amy K Schulze, Amy E Liepert, Ann P O'Rourke","doi":"","DOIUrl":"","url":null,"abstract":"Background: Simulation-based medical education, an educational model in which students engage in simulated patient scenarios, improves performance. However, assessment tools including the Oxford Non-Technical Skills (NOTECHS) scale require expert assessors. We modified this tool for novice use.Methods: Medical students participated in 5 nontechnical simulations. The NOTECHS scale was modified to allow for novice evaluation. Three novices and 2 experts assessed performance, with intraclass correlation used to assess validity.Results: Twenty-two learners participated in the simulations. Novice reviewers had moderate to excellent correlation among evaluations (0.66 < intraclass correlation coefficients [ICC] < 0.95). Novice and expert reviewers had moderate to good correlation among evaluations (0.51 < ICC < 0.88).Discussion: The modified NOTECHS scales can be utilized by novices to evaluate simulation performance. Novice assessment correlates with expert review. These tools may encourage the use of simulation-based medical education.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surveillance for the Rare Condition of Sickle Cell Disease in Wisconsin. 威斯康星州罕见镰状细胞病的监测。

Wisconsin Medical Journal Pub Date : 2022-12-01

Ashima Singh, Mahua Dasgupta, Dawn Retherford, Mei Baker, Mary Hulihan, Amanda M Brandow

引用次数: 0

Increased Alcohol-Related Mortality in Wisconsin Pre-COVID: A Two-Decade Trend. 威斯康星州新冠肺炎前酒精相关死亡率上升:二十年趋势

Wisconsin Medical Journal Pub Date : 2022-12-01

Lynne Cotter, Thomas Bentley, Pamela Imm, Paul D Creswell

{"title":"Increased Alcohol-Related Mortality in Wisconsin Pre-COVID: A Two-Decade Trend.","authors":"Lynne Cotter, Thomas Bentley, Pamela Imm, Paul D Creswell","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Alcohol-related mortality is increasing nationally, but state-specific trends still need to be explored. This paper reviews the patterning of alcohol-related deaths among Wisconsin residents in the 2 decades prior to the COVID-19 pandemic.Methods: Data are from death certificates for state residents from 2000 through 2019. We used underlying cause of death codes (ICD-10) to classify deaths as 100% attributable to alcohol (ie, acute, chronic liver, and other chronic). Demographic characteristics were available for the most recent decedents (2015-2019). We assess trends in alcohol-related mortality and used chi-square tests to assess demographic differences compared to deaths from all other causes.Results: The number of alcohol-related deaths more than doubled from 2000 through 2019 in Wisconsin, rising from 394 in 2000 to 857 in 2019. In the 5 most recent years (2015-2019), the populations with significantly higher rates of alcohol-related deaths included men, middle-aged adults, Black residents, and those of Hispanic descent. Education level also was significantly related to alcohol-attributable mortality, as those with the highest and lowest education levels were the least likely to die from this cause.Discussion/conclusions: Results of these analyses show that the number of deaths due to alcohol-related diseases has risen significantly since 2000, and this trend preceded the COVID-19 pandemic. These rising mortality rates deserve the attention of the medical and public health communities. Our findings show that, in recent years, Hispanic individuals, men, and middle-aged adults are at a higher risk for alcohol-related deaths. Stakeholders may wish to consider interventions targeted to these groups.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated Histoplasmosis: An Unusual Cause of Bowel Obstruction. 弥散性组织胞浆菌病:肠梗阻的一种罕见病因。

Wisconsin Medical Journal Pub Date : 2022-12-01

Kent J Peterson, Michael R Rose, Caroline Davitt, Kirk A Ludwig

{"title":"Disseminated Histoplasmosis: An Unusual Cause of Bowel Obstruction.","authors":"Kent J Peterson, Michael R Rose, Caroline Davitt, Kirk A Ludwig","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Although histoplasmosis is an extremely rare cause of bowel obstruction, this case describes disseminated gastrointestinal histoplasmosis as it progresses from acute colitis to subacute recurrent bowel obstructions.Case presentation: A White man in his early 80s with history of multiple myeloma presented to the emergency department with lightheadedness and diarrhea. Following a diagnostic journey for unspecified colitis, urine antigen testing and endoscopic biopsies led to the diagnosis. During the initial 12 weeks of antifungal treatment, the disease process transitioned from an acute inflammatory syndrome into a recurrent bowel obstruction.Discussion/conclusions: Only one other case of histoplasmosis causing recurrent bowel obstruction has been reported; however, that patient succumbed to the disease without surgical intervention. No clear guidelines exist of how to manage bowel obstructions from rare infectious sources, such as histoplasmosis, but close surveillance, multidisciplinary care, and an understanding of gastrointestinal pathology can guide clinicians when encountering atypical etiologies of bowel obstruction.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intractable Seizures in Children With Type 1 Diabetes: Implications of the Ketogenic Diet. 1型糖尿病儿童难治性癫痫发作:生酮饮食的意义。

Wisconsin Medical Journal Pub Date : 2022-12-01

Kimberly K Vidmar, Allison J Pollock

{"title":"Intractable Seizures in Children With Type 1 Diabetes: Implications of the Ketogenic Diet.","authors":"Kimberly K Vidmar, Allison J Pollock","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The ketogenic diet is prescribed for seizures in some children with epilepsy. Children with type 1 diabetes are at risk for diabetic ketoacidosis caused by ketosis due to decreased insulin effect. Currently there are no clinical guidelines regarding the safety and efficacy of the ketogenic diet in patients with concurrent epilepsy and type 1 diabetes.Objectives: This review examines the current literature regarding the association between TID and epilepsy, proposed mechanisms for the observed relationship, risks and benefits of the ketogenic diet, and clinical applications of the ketogenic diet in the context of type 1 diabetes and epilepsy.Methods: PubMed was used to identify relevant articles. Key search terms included, \"type 1 diabetes,\" \"ketogenic diet,\" \"seizure,\" \"epilepsy,\" and \"autoimmunity.\"Results: There is an observed association between type 1 diabetes and epilepsy, with proposed mechanisms including genetic predisposition, anti-glutamic acid decarboxylase (GAD) antibodies, metabolic derangements and cerebrovascular damages. Case reports describe the use of the ketogenic diet for epilepsy management in children with diabetes with mixed results; however, there are no large, randomized controlled trials to evaluate the broader application of these findings.Conclusions: In summary, there is inadequate evidence to support the use of the ketogenic diet in patients with coexisting epilepsy and type 1 diabetes in clinical practice. Further research is needed to determine the effectiveness, safety, and monitoring parameters of the ketogenic diet for these patients. The risks and benefits of the ketogenic diet as medical nutrition therapy for patients with both type 1 diabetes and epilepsy should be considered on an individualized basis.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10588993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Harnessing Data to Foster Research and Improve Population Health. 利用数据促进研究和改善人口健康。

Wisconsin Medical Journal Pub Date : 2022-12-01

Jomol P Mathew, Robert N Golden

引用次数: 0

Helping Residents Excel in Team-Based Care: An Interactive Case-Based Interprofessional Education Curriculum. 帮助住院医师在团队护理中脱颖而出:一个基于案例的互动式跨专业教育课程。

Wisconsin Medical Journal Pub Date : 2022-12-01

Cecilia Scholcoff, Katherine Sherman, Jessica Kuester, Amy Farkas

引用次数: 0