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The mean rate of correct responses was 45.3% (+/- 21.8%). Subgroup analysis failed to reveal any correlation between any of the secondary characteristics and correct responses. Conclusion Clinical educators in our study were not able to distinguish between competencies and EPAs. Further research is recommended prior to intensive curricular changes.Introduction Technology provides a platform to help address individualized training needs for community preceptors who are separated from the campus and pressured to achieve clinical productivity goals. This study explores technology use and support for delivering faculty development to community preceptors. Methods This cross-sectional study was part of the 2017 Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) annual survey of family medicine clerkship directors in the United States and Canada. Results The majority of respondents (n=62, 68.9%) agreed or strongly agreed that "using technology is critical to the successful delivery of faculty development to community preceptors." Only one-third (n=31) agreed or strongly agreed that their institution offers them adequate support to create and deliver technology-mediated faculty development or offers adequate support to community preceptors for accessing and using technology. Conclusions Clerkship directors need institutional support to provide effective faculty development to preceptors via technology. The opportunity exists for institutions, national organizations, and professions to collaborate across disciplines and health professions on technology-based faculty development to support a level of quality and engagement for faculty development that is consistent with the levels we bring to student education.From January 31 through February 3, 2019 the Society of Teachers of Family Medicine (STFM) held its 45th annual Conference on Medical Student Education in Jacksonville, Florida. STFM is a collaborative organization composed of members who are dedicated to teaching the discipline to learners of any level. The conference brings together members including physicians, administrators, behavioral scientists, researchers, residents, and students to learn from one another and improve the quality of family medicine education in the United States and Canada. Abstracts for all conference submissions can be found on the STFM website.1 Plenary speakers addressed topics related to health equity (Joanne Rooney, JD, LLM, EdD); discrimination and bias in the medical workplace (Roberto E. Montenegro, MD, PhD); and mentoring in family medicine (Beat Steiner, MD, MPH, STFM President). The STFM Committee on Medical Student Education reviewed the 14 completed educational research projects and selected six exemplary abstracts as the best of the conference. Criteria for inclusion included relevance to medical student education with a focus on family medicine education, study quality, and meaningful conclusions. Five of the abstracts appear in this collection. One has been published in the intervening time.2.Introduction Family physicians provide care to a growing and often complex group of older adults. Family medicine residencies are expected to prepare trainees to manage the medical and social needs of these seniors, but whether they feel prepared to do so is unknown. This study aimed to assess family medicine residents' sense of preparedness to address geriatric-related issues, and to identify factors that might affect this self-evaluation. Methods As an exploratory cross-sectional study, a 28-item questionnaire was circulated among 180 McGill University family medicine residents for voluntary completion. The survey assessed residents' demographics, attitudes toward, and perceptions of their training in geriatrics. Results One hundred residents (55.5% response rate) completed the questionnaire. Residents perceived their level of preparedness increasing as they progressed in their training; however, they felt least comfortable managing behavioral problems and engaging community resources. Positive perceptions about their training for geriatric care was proportionate to the number of positive role models they had during training. Sense of preparedness was most strongly and significantly associated with the duration of exposure residents had to long-term care. Conclusion The aging population requires physicians who are interested in care of the elderly and who are adequately prepared through comprehensive training to care for the complex medical and social issues that affect this large segment of society. This study, through its survey of family medicine residents, provides insights about potential curriculum changes and recommendations for updating the approach to care of the elderly.Lung cancer is the second most common cancer and the wide adoption of electronic health records (EHRs) offers a potential of accelerating cohort-related epidemiological studies using informatics approaches. In this study, we developed and evaluated a natural language processing (NLP) system to extract information on stage, histology, grade and therapies (chemotherapy, radiotherapy and surgery) automatically for lung cancer patients from clinical narratives including clinical notes, pathology reports and surgery reports. Evaluation showed promising results with the recalls for stage, histology, grade, and therapies achieving 89%, 98%, 80%, and 100% respectively and the precisions were 71%, 89%, 90%, and 100% respectively. This study demonstrated the feasibility and accuracy of extracting related information from clinical narratives for lung cancer research.In this study, we present a new method for detecting attributes of medical concepts, which uses a sequence labeling approach to recognize attribute entities and classify relations between concepts and attributes simultaneously within one step. A neural architecture combining bidirectional Long Short-Term Memory networks and Conditional Random fields (Bi-LSTMs-CRF) was adopted to detect disorder-modifier pairs in clinical text. Evaluations on the ShARe corpus show that the proposed method achieved higher accuracy and F1 scores than the traditional two-step approaches, indicating its potential to accelerate practical clinical NLP applications.This case study describes the implementation of the Research Electronic Data Capture (REDCap) software at the United States Department of Veterans Affairs Veterans Health Administration (VA). VA REDCap enables secure and standardized data collection, fosters collaboration with external researchers through use of a widely used data management tool, facilitates multisite studies through use of data forms that can be shared across sites within and outside the VA, is well suited to health services research studies and quality improvement projects, and enables exporting data for analysis in the VA secure computing environment. Using a diffusion of innovation framework approach, authors explore organizational factors that shaped adoption of REDCap technology and constraints on its use within the VA. Lessons learned from the VA experience are discussed.Improvements in the medical management of heart failure have changed the course of the disease. However, mortality rates, hospitalization rates, and treatment costs are not at desired levels. Diuretics have been widely used in the treatment of congestion in heart failure patients. The following case reports represent a special patient group treated and followed by cardiology clinic. Treatment approach of each case report has been tailored on an individual basis depending on the clinical course and hospitalization rates of patients. Authors have highlighted and discussed the common aspects and future perspectives of their cases in which post-discharge intermittent empirical intravenous diuretic administration dramatically improved the clinical status and readmission number due to decompensated congestive heart failure. Protein Tyrosine Kinase inhibitor This is a relatively new and promising approach, which has been thought to cease the recycle of diuretic resistance and silent increase of fluid congestion in patients with congestive heart failure and frequent hospitalization.Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in type 2 diabetes (T2D) patients. Recent cardiovascular outcome trials demonstrated clear cardiovascular benefits of novel classes of glucose-lowering agents. We performed retrospective electronic health record review at two major healthcare systems in the USA to determine the relative frequencies of outpatient encounters (hence prescribing opportunities) that a patient with T2D and CVD had with a cardiologist vs. an endocrinologist over one-year period. Of 109 747 T2D patients, 42.6% had established CVD. The ratio of cardiology-to-endocrinology outpatient encounters was 2.01 for all T2D patients, and 4.11 for those with T2D and CVD. Because each outpatient encounter provides an opportunity to discuss glucose-lowering medications with cardiovascular benefits, the much greater frequency of cardiology encounters highlights the emerging potential for cardiovascular specialists to influence or even implement evidence-based glucose-lowering therapies, thereby improving cardiovascular outcomes in their T2D patients.Brain natriuretic peptide (BNP) is elevated in decompensated systolic and diastolic heart failure. The plasma levels of adipokines, such as adiponectin and leptin, may provide evidence for mechanistic differences in BNP concentrations. African-American-specific associations are limited in the literature. The objective of this study was to evaluate the associations of adiponectin and leptin with BNP among African Americans. Methods Linear and logistic regressions were used to test the associations between adiponectin, leptin, and plasma BNP in 3738 participants of the Jackson Heart Study (JHS), a single-site prospective cohort study of African Americans in Jackson, Mississippi. Results A direct relationship of adiponectin was observed in multiple multivariate-adjusted linear models in men (β = 0.41-0.47), and in women (β = 0.32-0.38). Those in the highest quartile of adiponectin expression were twice as likely to have elevated BNP levels after adjustment [odds ratio 2.66 (95% confidence interval, 1.66-4.34)]. An inverse relationship of leptin with BNP was observed (β = -0.15) but attenuated after adjustment for aldosterone, renin, and adiponectin. Conclusions Different linear associations of adiponectin and leptin with BNP were observed. Odds of elevated adiponectin were observed with elevated BNP in multivariate-adjusted models. This paradoxical relationship of adiponectin and plasma BNP is possibly explained through adiponectin resistance.To identify sociodemographic and metabolic correlates of weight categories in postmenopausal women. link2 Methods The Women's Health Initiative enrolled 161 808 postmenopausal women ages 50-79. We included those free of cardiovascular disease (CVD) and with CVD risk factors and biomarkers (n = 19 412). Normal weight was defined as a BMI ≥18.5 and less then 25 kg/m2 and waist circumference less then 88 cm and overweight/obesity as a BMI ≥25 kg/m2 or waist circumference ≥88 cm. link3 Metabolically healthy was based on less then 2 and metabolically unhealthy ≥2 traits triglycerides ≥150 mg/dl, systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥85 mmHg or antihypertensives or diuretics, fasting glucose ≥100 mg/dl or diabetes medication, and high-density lipoprotein cholesterol less then 50 mg/dl. Polytomous multinomial logistic regression with generalized link logit function provided the odds of metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO) according to demographic and risk factor measures.

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