Beaumont Health

About: Beaumont Health is a nonprofit organization based out in Royal Oak, Michigan, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 1483 authors who have published 1448 publications receiving 15407 citations. The organization is also known as: William Beaumont Health System & Beaumont Hospitals.

The developing paradigm of urologic training in the USA

Abstract: have qualified instructors and an appropriate clinical learning environment. The spectrum of urological patients and procedures must be broad and include the multiple subspecialties of urology. The goal is to train residents to be competent to practice urology independently and without supervision within a 5or 6-year training program. The training program includes an initial year of internship in general surgery and all residents should have completed an M.D. degree or equivalent at an accredited institution. We are in a new era of training that emphasizes professionalism, communication skills and compassion for patients. Residents, attending physicians and related medical coworkers should work in an environment of mutual respect. Such an environment was not necessarily emphasized in the past. Guidelines founded through evidence-based study and a curriculum driven by the AUA University supports a more uniform outline for resident training. Competency-based training is now mandated and involves teaching and monitoring programs in the training of urology in six specified domains. (1) Medical Knowledge (2) Patient Care (3) System-Based Practice (4) Practice-Based Learning and Improvement (5) Interpersonal and Communication Skills and (6) Professionalism. A detailed discussion of these specific competencies is available at ACGME.org. Each resident must be evaluated with progress monitored by a competency committee formed of delegated instructors trained in evaluation. Resident progress and achievement of a competency in specific milestones of their training is documented with hope that the resident progresses toward complete competence by the end of their training. Progress in building a fund of urologic knowledge is monitored by an annual inservice exam, which simulates the experience of an actual board exam for graduates. The American public and government, which support residency training, mandate such Similar to the practice of urology, modern training of urologists has undergone dramatic evolution in the last three decades. The rapid pace of change is such that without continuous learning, the well-trained surgeon of 1990 might be incompetent today. To keep pace with these changes, training programs have embraced systematic learning modules and new technology along with more conventional teaching in the operating room to successfully prepare the next generation of urologists. The best training paradigm does not exist but is in continual evolution. The US paradigm for training and maintenance of skills as it currently exists is discussed so that training programs in other countries may compare and contrast for their best practice and development. Resident training in the USA is regulated and monitored by the Accreditation Council for Graduate Medical Education (ACGME) with each specialty having a Residency Review Committee (RRC), which establishes the requirements for certification of a residency training program. The ACGME is composed of member organizations representing physicians, hospitals and medical colleges for a coordinated program of graduated medical education. The RRC for urology is responsible for the monitoring and continued accreditation of urologic programs. The responsibility of running a urologic training program and the documentation of training and evaluating residents falls under a named Program Director who must be approved by the ACGME and have an appropriate academic portfolio and level of experience. The urology training program must

Characterization of a Novel Melt Curve by Use of the Roche LightCycler HSV 1/2 Analyte-Specific Reagent Real-Time PCR Assay: Frequencies of This Novel (Low) Melt Curve and Commonly Encountered (Intermediate) Melt Curves

Abstract: We characterize a novel probe binding-site polymorphism detectable solely by melt curve analysis using the Roche LightCycler HSV 1/2 analyte-specific reagent real-time PCR assay. The frequencies of this novel (47°C) and previously described intermediate (60 to 62°C) melt curves were 0.016% and 4.9%, respectively.

Exposure of articular chondrocytes to wear particles induces phagocytosis, differential inflammatory gene expression, and reduced proliferation

Abstract: The production of wear debris particulate remains a concern due to its association with implant failure through complex biologic interactions In the setting of unicompartmental knee arthroplasty (UKA), damage and wear of the components may introduce debris particulate into the adjacent, otherwise, healthy compartment The purpose of this study was to investigate the in vitro effect of polymeric and metallic wear debris particles on cell proliferation, extracellular matrix regulation, and phagocytosis index of normal human articular chondrocytes (nHACs) In culture, nHACs were exposed to both cobalt-chromium-molybdenum (CoCrMo) and polymethyl-methacrylate (PMMA) wear debris particulate for 3 and 10 days At 3 days, no significant difference in cell proliferation was found between control cells and cells exposed to both CoCrMo or PMMA particles However, cell proliferation was significantly decreased for CoCrMo exposed nHACs at both 6 (P < 0001) and 10 days (P < 0001) and PMMA at 10 days (P < 0001) Target gene expression displayed both a time- and material-dependent response to CoCrMo and PMMA particles Significant differences in COL10A1, ACAN, VCAN, IL-1β, TNF-α, MMP3, ADAMTS1, CASP3, and CASP9 regulation were found between CoCrMo and PMMA exposed nHACs at day 3 with gene regulation returning to near baseline at 10 days Results from our study indicate a role of wear debris induced cartilage degeneration after exposure to polymeric and metallic wear debris particulate, suggesting an additional pathway of cartilage breakdown, potentially manifesting in traditional clinical symptoms

Implementing Effective Policy in a National Mental Health Reengagement Program for Veterans.

Abstract: Policy is a powerful motivator of clinical change, but implementation success can depend on organizational characteristics. This article used validated measures of organizational resources, culture, and climate to predict uptake of a nationwide Veteran's Health Administration (VA) policy aim

Impact of Electronic Medical Record Alerts on Emergency Physician Workflow and Medical Management.

Abstract: Background Electronic medical record (EMR) alerts are automated messages that notify the physician of important information. However, little is known about how EMR alerts affect the workflow and decision-making of emergency physicians (EPs). Study Objectives This study aimed to quantify the number of EMR alerts EPs receive, the time required to resolve alerts, the types of alerts EPs receive, and the impact of alerts on patient management. Methods We performed a prospective observational study at a tertiary care ED with 130,000 visits annually. Research assistants observed EPs on shift from May to December 2018. They recorded the number of EMR alerts received, time spent addressing the alerts, the types of alerts received, and queried the EP to determine if the alert impacted patient management. Results Seven residents and six attending physicians were observed on a total of 17 shifts and 153 patient encounters; 78% (119) of patient encounters involved alerts. These 119 patients triggered 530 EMR alerts. EPs spent a mean of 7.06 s addressing each alert and addressed 3.46 alerts per total patient seen. In total, EPs spent approximately 24 s per patient resolving alerts. Only 12 alerts (2.26%) changed clinical management. Conclusion EPs frequently receive EMR alerts, however, most alerts were not perceived to impact patient care. These alerts contribute to the high volume of interruptions EPs must contend with in the clinical environment of the ED.