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  • ISSN: 2379-0547
    Volume 4, Issue 6
    Short Communication
    Erin Pete Devon*, Jeanine Ronan, Rebecca Tenney-Soeiro, and Dorene Balmer
    Objective: To identify the current state of intern preparatory courses (IPCs) at medical institutions through a national survey of pediatric educators. Specifically to learn more about the structure, curricular content and assessment of IPCs for fourth year medical students.
    Methods: An eight-question peer-reviewed survey, embedded in a larger survey, was distributed in 2016 to all members of the Council on Medical Student Education in Pediatrics (COMSEP). Responses were de-identified, distributed to investigators, and analyzed. Descriptive statistics were calculated for close-ended items, and free-text responses were reviewed for common concepts.
    Results: During the 45-day study period, 165 (40.1%) COMSEP members from 96 (63.2%) medical schools responded to at least one survey question. Seventy-nine (47.9%) respondents were pediatric clerkship directors that represented a discrete medical school and comprised the study sample. Forty-two (53.2%) clerkship directors in the sample reported that their medical school had at least one IPC. Of the clerkship directors who responded “yes” to their medical school having an IPC, 11 (26.2%) reported that their school had a pediatric-specific IPC and 17 (40.5%) reported an elective or required pediatric pathway within an IPC. The IPCs described by the clerkship directors varied widely in structure, curricular content, and learner assessment.
    Conclusion: Less than one-half (44%) of the responding U.S. medical schools have an IPC. Standardization of an IPC curriculum across schools could help ensure that medical students are similarly prepared for internship.
    Kali Patterson*, Patrick Marius Koga, and Marisa Ramos
    Background: Despite the well documented mental health vulnerability of refugees, the paucity of validated screening instruments for this population has delayed the implementation of routine refugee mental health screening in the United States.
    Method: This pilot screening project assessed the performance of three brief mental health screening tools (PC-PTSD, GAD-2 and PHQ-2) in detecting symptoms of post-traumatic stress disorder, anxiety and depression in a diverse sample of refugees undergoing standard post-arrival health assessments in Sacramento, California.
    Results: Of the 1,643 refugees nearly 16% (n=262) screened positive for at least one mental health condition. Compared to follow-up scores on the PCL-C, BAI and BDI-II, all three screening tools demonstrated moderate sensitivity (PC-PTSD; 80%; GAD-2: 81%; PHQ-2: 73%).
    Conclusion: These findings warrant the integration of standardized mental health screening into routine refugee health assessments in the state of California. Further prospective research is necessary to establish screening generalizability in a broad range of refugee populations.
    Neil Baker*, Ann Lefebvre, and Cory Sevin
    The evidence base for the use of practice facilitators to assist ambulatory care practices in transforming care delivery is growing. While the role of the practice facilitator is still developing; it is showing promise as a beneficial delivery model to help primary care practices transform to meet the higher functioning demands of the US healthcare system. However, if applied poorly, the practice facilitator role may inadvertently add a layer of staffing to a practice as opposed to building the capacity of existing staff to learn new roles and skills. In this article, we describe a new diagnostic framework to assist practice facilitators in applying the most appropriate delivery mechanism for information needed to build a practice’s capacity. The ultimate aim is for practices to create and sustain improvement in their care delivery.
    Research Article
    SM Mostafa Kamal*, M. Anisur Rahman MPhil, and Towhiduzzaman
    Objective: This study examined the influence of family planning workers on postpartum modern contraceptive use among Bangladeshi women.
    Materials and methods: The study used the latest 2014 Bangladesh Demographic and Health Survey data. A total of 1710 women were extracted from the nationally representative data set as eligible women for this study. Both bivariate and multivariate statistical analyses were employed to analyze the data. The association between the selected independent variables along with home visitation by family planning workers and postpartum family planning method use was assessed by chi-square tests. Multivariate logistic regression models were constructed to examine to what extent the home visitation of family planning worker influence the postpartum contraceptive use. The results of the analysis are presented by odds ratios (OR) with 95% confidence interval (CI).
    Findings: Of the study women, only 27% women were visited by family planning workers. The use rate of postpartum modern family planning method was 49%. The multivariate analysis employed in the study yielded quantitative important and reliable estimates of postpartum modern contraceptive use. Compared to the women who were not visited, the women who were visited by family planning workers were significantly (p<0.01) more tended (OR=1.36; 95% CI=1.09-1.69) to be the postpartum modern family planning method users. The other factors identified to have influence on the use of modern contraceptive method during postpartum period are women’s education, place of residence, religion and wealth index.
    Conclusion: Family planning workers should increase their visitations and should focus more on providing the necessary information to pregnant women and their partners to increase the usage of PPFP methods for long run benefits of maternal and child health.
    Soumi Roy Chowdhury*, Alok K. Bohara, Dipesh Tamrakar, Jeffrey Drope, and Biraj Karmacharya
    In the absence of a national cancer registry system in Nepal, the objective of our study is to bring in current cancer incidence data through a primary survey across five different cancer hospitals of Nepal. The study helps in understanding the prevalence of cancer and also in examining the barriers behind proper utilization of cancer preventative measures. Through cluster analysis using Local Moran’s I and Getis-Ord G*, we have identified hot spots of cancer cases across Kathmandu Valley, the central development region of Nepal. The spatial analysis implies the presence of clusters of cancer incidences in that region. Finally, through regression analysis, we tried to quantify the impact of distance and accessibility to information on patients’ likelihood to screen for cancer. We ran three different specifications each of Probit and Negative Binomial model to establish the relationship. From our empirical regression analysis, we found that if a patient had to travel a distance of more than 10 hours to avail medical services, it would significantly reduce their likelihood to screen. Whereas any informational, intervention had significantly increased the probability of undertaking cancer screening tests. Other socio-economic factors such as income and employment status also play important roles in medical care utilization. The results are uniform across both the probit and negative binomial models.
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