A Systems Approach to Person-Centric Health Economics.

The economics of health and the economics of health care are not the same, and in fact can be competitors for resources in some cases. Using a traditional supply/demand framework can clarify the forces at work in person-centric health economics. Use of cost-effectiveness analysis, employing a broader systems perspective that incorporates sectors other than health care, and nudging individuals to better health habits are three strategies that can help to drive a shift from health care to health.

Family nurse practitioner student perception of journal abstract usefulness in clinical decision making: a randomized controlled trial.

PURPOSE: To assess family nurse practitioner (FNP) student perception of research abstract usefulness in clinical decision making. DATA SOURCES: A randomized controlled trial conducted in a simulated environment with graduate FNP students of the Graduate School of Nursing, Uniformed Services University of the Health Sciences. Given a clinical case study and modified MEDLINE search tool accessible via an iPad device, participants were asked to develop a treatment plan and complete a data collection form. The primary measure was perceived usefulness of the research abstracts in clinical decision making regarding a simulated obese patient seeking to prevent type 2 diabetes. Secondary measures related to participant demographics and accessibility and usefulness of full-text manuscripts. CONCLUSIONS: The majority of NP students identified readily available research abstracts as useful in shaping their clinical decision making. The presence or absence of full-text manuscripts associated with the abstracts did not appear to influence the perceived abstract usefulness. The majority of students with full-text manuscript access in the timed simulated clinical encounter read at least one paper, but cited insufficient time to read full-text as a constraint. IMPLICATIONS FOR PRACTICE: Research abstracts at point of care may be valuable to FNPs if easily accessible and integrated into clinical workflow.

Behavioral and nutritional aspects of the Virginian opossum (Didelphis virginiana).

Virginia opossums are widely distributed throughout the United States, except in the most arid regions, and wild individuals are commonly brought to practitioners for medical attention. Opossums' popularity as pets seems to be growing, and it is likely that pet opossums will be more common in veterinary practice. Clinicians must be aware of natural opossum behaviors so that thorough physical examination and diagnostic procedures can be performed on injured patients. For animals kept captive long-term or as pets, veterinarians must understand proper nutrition and nutritional disorders, such as secondary nutritional hyperparathyroidism, obesity, and dental disease, to properly treat this species.

Visions and viewpoints: promises and reality.

The immediate past chair of the ADA Council on Ethics, Bylaws and Judicial Affairs, who is also an attorney, explains why, after a thirty-year absence, he went back to treating Medicaid patients. It is easy to identify the social, political, bureaucratic, and financial shortcomings of our imperfect system. But how else, besides participating, can one educate patients so the dentist and the patient can both accept responsibility? How else can the profession make a difference except one patient at a time?

Comparing learning environments in U.S. military officer education: a brief replication.

A 2003 comparative study on learning environments at two military officer training sites was replicated using different methodology. Satisfaction with learning environment and with administrative inprocessing was higher at Fort Leavenworth than at Fort Dix. Most students expressed a preference for Fort Leavenworth. Satisfaction with institutional support and educational facilities appears to influence perceived satisfaction with a learning environment and with preference for training sites among senior military officers.

Comparing learning environments in U.S. military officer educational settings: a field test.

U.S. Army field grade officers who had attended two military schools evaluated two learning environments. For a majority of variables studied, the subjects reported higher satisfaction with institutional support at Fort Leavenworth as opposed to the other site. Satisfaction with that institutional report was strongly related to satisfaction with lodging used (hotels), quality of instruction, and the culture of an active duty installation. Most of the subjects (72-82%) expressed a preference for attending the Command and General Staff College course at Fort Leavenworth, if given a choice.