The Journal of the American Osteopathic Association
-
J Am Osteopath Assoc · Oct 2018
Interrater Reliability of Osteopathic Sacral Palpatory Diagnostic Tests Among Osteopathy Students.
Somatic dysfunctions are a key element of osteopathic practice. The evaluation of somatic dysfunctions is achieved by assessment of the TART (tissue texture abnormality, asymmetry, restriction of motion, tenderness) parameters. The reliability of a diagnostic method is the crux of successful treatment. Interrater reliability of osteopathic palpatory diagnostic tests have been studied on different anatomical areas, but there are no studies on the evaluation of all of the TART parameters on the sacrum. ⋯ Results showed a level of agreement ranging from slight to fair in the assessment of the TART parameters among raters, who were in their last year of osteopathy school. The tenderness parameter was the most reliable. Our findings are consistent with other interrater reliability studies carried out in different body regions, contributing to show an overall heterogeneous level of diagnostic reliability in osteopathy.
-
J Am Osteopath Assoc · Jul 2018
Oral Health Training in Osteopathic Medical Schools: Results of a National Survey.
Oral health is a critical aspect of overall health, yet many vulnerable communities struggle to access regular dental care and instead seek urgent treatment from physicians. In addition to addressing the consequences of untreated dental disease, physicians are in an ideal position to provide preventive and referral dental services to patients. Osteopathic physicians make up a substantial portion of the physician workforce and can play a central role in increasing oral health care provision in medical settings. ⋯ Oral health education is present at many osteopathic medical schools, but the content covered and the extent of training varies considerably.
-
J Am Osteopath Assoc · Jul 2018
Case ReportsPerplexing Rash: Challenges to Diagnosis and Management of Mycosis Fungoides.
Mycosis fungoides is the most ubiquitous form of cutaneous T-cell lymphoma. Diagnosis is arduous, as early phases often resemble common inflammatory dermatoses. ⋯ The authors present a case of a 69-year-old man with mycosis fungoides, followed by a review of diagnostic modalities and phototherapeutic interventions for patients with this condition. According to literature reports, monochromatic excimer light therapy is the most advantageous and well-tolerated phototherapy modality for patients with early patch stage mycosis fungoides.
-
J Am Osteopath Assoc · May 2018
Laboratory Tests and X-ray Imaging in a Surgical Intensive Care Unit: Checking the Checklist.
Patients in the surgical intensive care unit (ICU) frequently undergo laboratory and imaging testing. These tests can lead to iatrogenic anemia and radiation exposure. Many of these tests may be unnecessary for the management of a patient's illness in the surgical ICU, and their ordering may be a reflex rather than in response to a clinical question. Checklists have been used in critical care to identify and address patient care strategies. ⋯ The addition of the diagnostic testing section to the daily checklist did not result in a reduction of the amount of tests ordered per day. Further research on test appropriateness and the possible addition of a clinician decision-making tool could be studied in the future to assist with reduction of tests ordered in the surgical ICU.
-
Faculty vitality is defined as the synergy between high levels of satisfaction, productivity, and engagement that enables faculty members to maximize their professional success and achieve goals in concert with institutional goals. Many studies have examined faculty development efforts with regard to satisfaction, retention, or vitality, but, to the authors' knowledge, they have all been conducted in allopathic medical schools and academic health centers. ⋯ The results of this study suggest that career satisfaction is a significant contributor to vitality in osteopathic medical school faculty members. Additionally, primary department climate and leadership is a significant predictor of faculty vitality. Responses to the open-ended questions further elucidated extrinsic factors that positively and negatively affect vitality, including family and home life and dwindling funding from national medical research agencies. Faculty development efforts should be directed toward enhancing contributors to vitality.