Antibiotic use in goats: role of experience and education of Missouri veterinarians.

BACKGROUND: In a previous study, we found that rates of antibiotic residues in goat carcasses in Missouri were three times the published national average, warranting further research in this area. METHODS: We conducted a cross-sectional survey of goat veterinarians to determine attitudes and practices regarding antibiotics, recruiting 725 veterinarians listed on the American Association of Small Ruminant Practitioners (AASRP) website and 64 Missouri Veterinary Medical Association (MVMA) veterinarians. RESULTS: We collected 189 responses (26.1%) from AASRP members (170 valid) and 8 (12.5%) from MVMA veterinarians totalling 178 responses. While the vast majority of all veterinarians indicated that they prescribed antibiotics less than half of the time, Missouri veterinarians indicated that they spent more time treating goats for overt disease like intestinal parasites and less time on proactive practices such as reproductive herd health management comparatively. While veterinarians agreed that antibiotic resistance was a growing concern, veterinarians outside of Missouri seemed more confident that their own prescription practices was not a contributor. Although nationally most veterinarians felt that attending continuing education classes was beneficial, 73.4% in other states attended classes on antibiotic use compared to only four of the nine Missouri veterinarians. CONCLUSION: Missouri veterinarians had less veterinary experience than veterinarians in other states, and this, in conjunction with low continuing education requirements in Missouri relative to most other states, may hinder development of more proactive and effective client-veterinary relationships.

An Evaluation of Permit L Local Anesthesia within Dental Hygiene Practice in Massachusetts.

PURPOSE: The purpose of this descriptive study was to assess data pertinent to the Permit L local anesthesia license among practicing dental hygienists in Massachusetts, providing an overview of characteristics, practice behaviors, barriers for obtaining the permit and self-perceived competency. METHODS: A convenience sample of dental hygienists (n=6,167) identified through a publically available data base were invited to participate in a web-based survey. The survey consisted of demographic and Permit L specific questions. Items regarding opinions were rated using a 5-point Likert scale while frequencies and percentiles were used to evaluate demographics and practice-based information. Spearman's Rank correlation was performed to determine association between variables. RESULTS: A 10% (n=615) response rate was attained with (n=245) non-Permit L holders and (n=370) Permit L holders. Respondents reported significant differences in demographics and opinions between non-Permit L holders and Permit L holders (p<0.01) and between those certified through continuing education or curriculum based programs (p<0.01). Significant relationships were found in demographics (p<0.01) and practice (p<0.05) items in relation to the length of time the Permit L has been held. Themes from the data and comments indicate multiple factors influencing obtaining or not obtaining the Permit L. CONCLUSION: The results of this study provide an overview of Permit L local anesthesia administration that is generally comparable to previous studies and offers new insights into why some Massachusetts dental hygienists choose not to pursue certification. This study highlights the potential to increase the prevalence of the Permit L, address barriers to pursuing the Permit L, and further evaluate self-perceived barriers.

Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals.

INTRODUCTION: This study aimed to assess confidence level of healthcare professionals in venipuncture and their knowledge on the possible causes of in vitro hemolysis. MATERIALS AND METHODS: A sample of 94 healthcare professionals (nurses and laboratory technicians) participated in this survey study. A four-section questionnaire was used as a research instrument comprising general information for research participants, knowledge on possible causes of in vitro hemolysis due to type of material used and venipuncture technique and specimen handling, as well as assessment of healthcare professionals' confidence level in their own ability to perform first and last venipuncture. RESULTS: The average score on the knowledge test was higher in nurses' than in laboratory technicians (8.11±1.7, and 7.4±1.5, respectively). The difference in average scores was statistically significant (P=0.035) and Cohen's d in the range of 0.4 indicates that there is a moderate difference on the knowledge test among the health care workers. Only 11/94 of healthcare professionals recognized that blood sample collection from cannula and evacuated tube is method which contributes most to the occurrence of in vitro hemolysis, whereas most risk factors affecting occurrence of in vitro hemolysis during venipuncture were recognized. There were no significant differences in mean score on the knowledge test in relation to the confidence level in venipuncture (P=0.551). CONCLUSION: Confidence level at last venipuncture among both profiles of healthcare staff was very high, but they showed insufficient knowledge about possible factors affecting hemolysis due to materials used in venipuncture compared with factors due to venipuncture technique and handling of blood sample.

Opinión de los médicos residentes de los hospitales catalanes sobre la formación en urgencias / Resident physicians' opinions of their emergency medicine training in Catalan hospitals

Objetivo: Conocer la opinión de los médicos internos residentes (MIR) de Cataluña acerca de la necesidad y utilidad de la formación recibida en los servicios de urgencias. Métodos: Se envió un cuestionario electrónico a los MIR de Cataluña mediante la colaboración de sus jefes de estudio. El cuestionario contenía variables sociodemográficas, preguntas sobre la predisposición del residente hacia las urgencias, y variables relacionadas con la formación: valoración de la necesidad de una estancia en urgencias, y conocimientos y aptitudes adquiridos durante la rotación (historia clínica, relación con los familiares, trabajo en equipo, toma de decisiones, identificación y manejo de pacientes críticos y aprendizaje de técnicas diagnóstico-terapéuticas). Se hicieron análisis descriptivos y se compararon los resultados entre distintas especialidades. Resultados: Se envió el cuestionario a 1.431 residentes de 21 hospitales y unidades docentes. Respondieron 427 residentes (29,8%). Tanto la valoración sobre la necesidad de realizar una formación en urgencias como sobre los conocimientos adquiridos fueron elevadas [8,9 (1,7) y 8,2 (1,9) puntos, respectivamente, en una escala de 1 a 10]. Los aspectos en los cuales habían adquirido mayor conocimiento fueron la toma de decisiones y el manejo de pacientes críticos. Los residentes de Medicina Familiar y Comunitaria mostraron mayor predisposición a escoger la especialidad de urgencias (33,7% frente a 6,1%, p < 0,001). Su valoración acerca de la necesidad de formarse en urgencias también fue superior [9,2 (1,5) frente a 8,7 (1,8), p = 0,006]. Conclusiones: Los MIR de Cataluña opinan que una estancia en urgencias durante su residencia es necesaria y útil para su formación. Los residentes de Medicina Familiar y Comunitaria son los que más valoran esta formación (AU)

Objective: To know the opinion of medical residents in hospitals in Catalonia about the need for and usefulness of the training they receive in the emergency department. Methods: We sent an electronic questionnaire to all residents in Catalonia, through their cooperating supervisors. The questionnaire contained items to collect information on sociodemographic variables and attitudes toward emergency medicine. Items related to training covered the residents’ assessment of the need for a rotation in the emergency department and the knowledge and skills acquired during the rotation (case history writing, relations with patients’ relatives, teamwork, decision-making, identifying and managing critical patients, acquisition of diagnostic and therapeutic techniques). We compiled descriptive statistics and compared the results for residents from different specialties. Results: Questionnaires were sent to 1431 residents in 21 hospitals and other training facilities. Responses were received from 427 (29.8%). Mean (SD) scores expressed on a scale of 1 to 10 were high for both the need for training in emergency medicine (8.9 [1.7]) and knowledge acquired during the rotation (8.2 [1.9]). The residents reported that they had acquired more knowledge in the areas of decision-making and management of critical patients. Family medicine residents expressed greater interest in choosing the specialty of emergency medicine (33.7% vs 6.1% for other residents, P<.001), and their opinion of the need for training in emergency medicine was also higher than other residents’ (9.2 [1.5] vs 8.7 [1.8], P=.006). Conclusions: Medical residents in Catalonia believe that a rotation in the emergency department provides necessary and useful training. Family medicine residents are the ones who value emergency training most highly (AU)

Awareness of the 2010 guidelines implemented by the New York State Education Department for respiratory therapists in their role as clinical preceptors.

BACKGROUND: In 1993, the New York State (NYS) legislature and governor signed into law the Respiratory Therapy Guide to Practice Education Law to guide and regulate the profession of respiratory care under the auspices of the New York State Education Department. New guidelines were implemented by the New York State Education Department for respiratory therapists (RTs) in 2010 to provide the opportunity for RTs to receive continuing education units (CEUs) when participating as clinical preceptors. This study was conducted in June 2012 to determine the extent to which the NYS RTs are aware of the new licensing guidelines and amendments. METHODS: In June 2012, a web-based survey was e-mailed to 2,503 NYS members of the New York State Society for Respiratory Care, 14% of which (n= 360) completed the survey. The survey included 21 items to assess RTs' awareness of the licensing guidelines that were implemented in 2010, and these respondents were analyzed using basic descriptive statistics. RESULTS: The study showed that 50% of the respondents were not aware of eligibility to earn CEUs as a clinical preceptor in NYS. Twenty-eight percent responded correctly that licensed RTs were eligible to earn CEUs as a clinical preceptor in NYS. In addition, 67% of those who responded were unaware of how many CEUs could be earned for each renewal period for clinical precepting. Finally, 70% of the respondents indicated that they would be inclined to seek employment at a facility that has a clinical affiliation with a university or college respiratory care program. CONCLUSIONS: The findings indicate that more education is needed in NYS to make licensed RTs aware of the 2010 guidelines. Practitioners may require incentives to become actively involved in the clinical education of respiratory care students as their clinical preceptors.

Making the case for primary care and mandated suicide prevention education.

During its 2012 legislative session, Washington State passed ESHB 2366, otherwise known as the Matt Adler Suicide Assessment, Treatment, and Management Act of 2012. ESHB 2366 is a significant legislative achievement as it is the first law in the country to require certain health professionals to obtain continuing education in the assessment, treatment, and management of suicide risk as a requirement to obtain and maintain licensure. However, ESHB 2366 does not apply to primary care providers, an important next step for legislation that has as its goal "to help lower the suicide rate in Washington." This commentary addresses objections raised against the law and potential responses as Washington considers strengthening its own law to include primary care providers and as other states consider similar legislation.

International guidelines for education in vestibular rehabilitation therapy.

The Barany Society Ad Hoc Committee on Vestibular Rehabilitation Therapy has developed guidelines for developing educational programs for continuing education. These guidelines may be useful to individual therapists who seek to learn about vestibular rehabilitation or who seek to improve their knowledge bases. These guidelines may also be useful to professional organizations or therapists who provide continuing education in vestibular rehabilitation. We recommend a thorough background in basic vestibular science as well as an understating of current objective diagnostic testing and diagnoses, understanding of common tests used by therapists to assess postural control, vertigo and ability to perform activities of daily living. We recommend that therapists be familiar with the evidence supporting efficacy of available treatments as well as with limitations in the current research.

Las Figuras Docentes de la Formación de Médicos Especialistas ante el Real Decreto 183/2008: El Jefe de Residentes y el Técnico Docente / Educators in Specialised Medical Training in view of the Royal Decree 183/2008: The Head of Residents in Training and the Teacher

El Real Decreto 183/2008 sobre Formación Médica Especializada en Ciencias de la Salud ha supuesto un cambio sustancial de esta formación en nuestro país. Desde su publicación, las Unidades Docentes (UU DD) han comenzado un proceso de adaptación a este decreto, proceso que es complejo y que requiere mucho esfuerzo ante los múltiples e importantes cambios que introduce. Este viaje presenta dificultades añadidas por el incumplimiento de las instituciones competentes de elaborar la normativa que desarrolle la mayoría de sus contenidos, y por lo tanto las UU DD carecen de las guías y orientaciones al respecto. Como iniciativa de la Comisión de Docencia de Formación Especializada del Hospital Universitario Virgen de la Arrixaca, se presenta el resultado del trabajo en grupo de los asistentes (informadores clave) al taller de Actualización en la Normativa sobre las Figuras Docentes en la Formación Sanitaria Especializada celebrado en Murcia, febrero de 2010. En este caso se centra en las propuestas elaboradas sobre las figuras del Jefe de Residentes y el Técnico Docente, con la intención de aportar ayuda para los jefes de estudios y los docentes en esta adaptación (AU)

The Spanish Royal Decree 183/2008 on Specialised Medical Training in Health Sciences has meant a substantial change to this kind of training in Spain. Since its publication, the Teaching Units (TUs) have started a process of adaptation to this decree, a process that is complex and that requires much effort in view of the many significant changes it introduces. The process is complicated even more because the competent institutions have failed to develop regulation on most of the Decree’s contents, leaving the TUs with no guidelines. As an initiative of the Education Committee on Specialised Training of the Hospital Universitario Virgen de la Arrixaca we present the results of the participant’s teamwork (key informers) in a workshop on the Update of the Regulation on Educators in Specialised Health Training that took place in Murcia in February 2010. In this case we focus on the proposals developed for the Head of Residents in training and Teachers, with the aim of providing support to the heads of studies and teachers in this adaptation (AU)