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  • ISSN: 2378-9328
    Volume 2, Issue 4
    Short Communication
    Jennifer L. Reed*, Jill S. Huppert, Regina G. Taylor, Gordon L. Gillespie, Evaline A. Alessandrini and Jessica A. Kahn
    Abstract:
    Purpose: In a sample of adolescents who tested positive for a sexually transmitted infection (STI) in an emergency department (ED), we aimed to evaluate whether post-visit telephone contact to inform individuals of their positive STI status, and provide education and referral to a medical home, was associated with a decrease in return ED visits for STI testing.
    Methods: In this retrospective cohort study, chi squared analysis was used to evaluate differences among adolescents by successful contact. A logistic regression analysis examined factors associated with return ED visits.
    Results: Among the 584 adolescents, successful contact was not significantly associated with a decrease in return ED visits when adjusting for all covariates (OR 1.66, 95% CI 0.93-2.97). Females were more likely to return to the ED for STI testing than males (AOR 1.87; 95% CI 1.19-2.95).
    Conclusions: Adolescents contacted regarding STI positive results did not have significantly different ED return visit rates for STI testing than those not contacted.
    Marufa Sultana, Rashidul Alam Mahumud and Abdur Razzaque Sarker*
    Abstract:
    In support of the provision of the need based health care delivery to any population, information on the existing disease pattern is crucial. This viewpoint has made an effort to present a picture of disease pattern of general population of Bangladesh who had taken services either as inpatient or outpatient in district level hospital. The picture of top ten diseases (based on mortality and morbidity) intended to suggest a need-based resource allocation considering the major diseases and the proportion of admitted patients in the facility.
    Angie Waliski*, James C. Townsend, Maria Castro, Rebecca Doan, MSW, JoAnn E. Kirchner, Richard R. Owen and Kenneth R Conner
    Abstract:
    Suicide is the 10th leading cause of death in the United States. In order to establish evidence-based best practices for suicide prevention, knowledge of suicide's etiology and effective prevention measures is crucial. However, Institutional Review Board (IRB) approval for studies involving suicidal participants may be difficult to obtain for a study that involves participants who may be deemed vulnerable. Furthermore, the detailed process of compliance with federally mandated regulations may seem daunting to a first-time investigator when submitting a study for IRB approval. This article describes the process of obtaining Institutional Review Board (IRB) approval for a proposed study of Veterans who experienced either a non-fatal suicide attempt or serious suicidal ideations involving a firearm, as well as strategies for ensuring success. A collaborative process involving IRB administrators, IRB members and study investigators resulted in study approval of a protocol design that met the study's objectives, educated the IRB on a subject population they were unfamiliar about, and safe-guarded Veteran confidentiality and safety.
    Review Article
    Dimitra S. Spyropoulou* and Amalia A. Ifanti
    Abstract:
    In this paper, we examine the concepts of health and health promotion through the declarations of the World Health Organization (WHO). The concept of health promotion was defined by the World Health Organization after the publication of the Ottawa Charter in 1986, as a process that helps to empower individuals and society to increase control over their environment and improve their health. In order to achieve the objectives for health promotion and support health in the international concept, the WHO requires governments to adopt "healthy" public policies.
    Research Article
    Moeen-uz-zafar*, Owayed Al Shammari and Badr Aljarallah
    Abstract:
    Objective: To evaluate the reliability and validity of the interactive OSCE in the subject of Medicine for medical students and how it is effected by the presence of internal and external examiners and to identify the appropriate duration of OSCE station.
    Methodology: We used the following parameters to evaluate the interactive OSCE process in internal medicine:
    Feedback from the candidate students (n=42 with 28 males and 14 females)
    Feedback from the external examiners (n=11)
    Feedback from the internal examiners(n=8)
    Determination of inter-rater variability at various stations
    Correlation between the OSCE and MCQ results
    Results: A high proportion of the student examinees found OSCE to be fair, addressing the course objectives (33/42; 78.6%) and covering a wide range of the skills (35/42; 83.3%).
    46% (n=13) of male candidates and 78% (n=11) of female candidates found OSCE to be very stressful (p=0.005). The duration of each station was found insufficient by 15/42 (35.7%) of candidates. 31/42 (73.8%) of students reported that language barrier seemingly affected their performance at the interactive OSCE stations.
    84 %of the external and internal examiners found OSCE to be satisfactorily covering the skills needed by a junior physician who will work under supervision but they also suggested the duration of station to be increased and few of the examiners mainly external examiners suggested an additional method of evaluation to be included. Minor interruptions were the main concern of the examiners during the exam, which can affect the reliability and validity of the exam. Patient's related care was the principle reason for interruption. The overall inter-rater variability was found to be low, with inter-rater agreement having kappa value 0.602 [SE 0.024; 95%CI 0.555-0.650].
    The correlation between the result of OSCE and the MCQ was found to be weakly positive with a Pearson correlation coefficient ‘r' of 0.6203 [p<0.001; 95% CI 0.4503 – 0.7703].
    Conclusion: The interactive OSCE in Medicine is generally a satisfactory method for the evaluation of medical students with internal and external examiners with inter-rater agreement of kappa value 0.602. Female students are more stressed in OSCE than male. Language barrier seems to affect the performance of candidates. Weak positive correlation was found between OSCE and MCQ exams as they assess different competencies.
    Case Report
    Michael S. Chen*
    Abstract:
    The Second Generation Reform of Taiwan's universal National Health Insurance (NHI) extended the coverage to inmates in the prison, beginning on January 1, 2013. Taiwan is unique among the few countries that had mainstreamed healthcare in prison because it takes the principle of insurance into the prisonin its totality. While the application of insurance principle in the prison without distinction from that for the general public appears to be a manifestation of equal footing for the inmates, it imparts a sense of entitlement on the one hand, and imposes cost-sharing on the other. Both may contravene the principle of incarceration. Throughout the world with very few exceptions, healthcare in prison is based on need, instead of entitlement, and is funded by the general tax without cost-sharing.
    Introduction of the NHI into the prison proved to be an effective solution to healthcare problems entrenched in the prison, yet taking the insurance principle in its totality into the prison may also create its own problems.
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