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buy water pills lasix. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Stephen Grossbart, Ph.D., Senior Vice President of Professional Services, has been re-appointed to National Quality Forum's (NQF) Primary Care and Chronic Illness Standing Committee.

Grossbart has served on the Committee since 2017 and its precursor, Pulmonary and Critical Care Standing buy water pills lasix Committee, since 2012. Commenting on the appointment, Grossbart said. "As our nation continues to face buy water pills lasix the unprecedented challenges of the hypertension, the implementation and effectiveness of healthcare quality measures and improvement strategies is of special importance. It's an honor to be named to NQF's Primary Care and Chronic Illness Standing Committee and I look forward to partnering with my fellow committee members to develop and advise on measures that will best support healthcare stakeholders and drive measurable improvements."Members of the Primary Care and Chronic Illness Standing Committee are responsible for overseeing measures related to endocrine, infectious disease, musculoskeletal and pulmonary care.

Measures endorsed by NQF are a benchmark for healthcare measurement in the United States and are critically important to healthcare outcomes improvement and efforts to treat and prevent chronic illness and infectious disease. About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services buy water pills lasix to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Media buy water pills lasix Contact:Amanda Hundtamanda.hundt@healthcatalyst.com575-491-0974 View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-leader-appointed-to-primary-care-and-chronic-illness-standing-committee-301204733.htmlSOURCE Health CatalystSALT LAKE CITY, Dec.

22, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst", buy water pills lasix Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Dan Burton, CEO, Bryan Hunt, CFO and Adam Brown, SVP of Investor Relations and FP&A, will participate in the 39th Annual J.P. Morgan Healthcare Conference buy water pills lasix to be held virtually January 11-14, 2021.

This will include a presentation by Mr. Burton and Mr. Hunt on Monday, January 11, buy water pills lasix 2021 at 5:20 p.m. EST.

An audio replay buy water pills lasix of the presentation will be available at https://ir.healthcatalyst.com/investor-relations. About Health Catalyst Health Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions buy water pills lasix of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.

Health Catalyst Investor Relations Contact buy water pills lasix. Adam BrownSenior Vice President, Investor Relations and FP&A+1 (855)-309-6800ir@healthcatalyst.com Health Catalyst Media Contact. Amanda HundtVice President, Corporate Communications+1 (575) 491-0974amanda.hundt@healthcatalyst.com.

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Sign up for our newsletter. The does lasix help with pneumonia rural counties with the highest death rates show that patterns of the lasix’s spread across the U.S. The highest death rates cluster in the Great Plains, from North Dakota down to the Texas Panhandle. Other hotspots include the Four Corners region, the Black Belt South, and the Texas borderlands. These regions were all part of earlier phases of the lasix, which initially spread does lasix help with pneumonia in rural areas through meatpacking plants, prisons, and nursing homes.

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Grant County grew from does lasix help with pneumonia 12 to 35. Brown County from 21 to 60. Eastern counties were also part of the December surge. In central Pennsylvania, Jefferson County saw a seven-fold increase in deaths in one month, growing from six to 43 does lasix help with pneumonia. Verango County, Pennsylvania, had a six-fold increase, from eight deaths to 47.

Rural counties helped http://www.kampfirejournal.com/?post_type=feedback&p=580 lead the way in making December the lasix’s deadliest month on record, ending the year with an emphatic reversal of the urban-focused buy water pills lasix manner in which the lasix began in the U.S. In early 2020. More than 16,000 hypertension medications-related deaths were reported in December in nonmetropolitan (rural) buy water pills lasix counties, about a fifth of the total 73,578 deaths that occurred in the U.S. Last month.

The rate of hypertension medications-related deaths in rural America was nearly twice the death rate of major metropolitan areas (ones with a million or more residents). That’s the opposite of buy water pills lasix the trend we saw in April. At the start of the lasix, deaths in the New York City metro resulted in a major-metro death rate five times higher than the rural death rate for month. Cumulatively in 2020, 51,221 rural Americans died from hypertension medications-related causes.

At the close of 2020, all but buy water pills lasix 10 of the 100 counties with the worst cumulative death rates were rural. Deaths in 2020 Like this story?. Sign up for our newsletter. The rural counties with the highest death rates show that patterns of the buy water pills lasix lasix’s spread across the U.S.

The highest death rates cluster in the Great Plains, from North Dakota down to the Texas Panhandle. Other hotspots include the Four Corners region, the Black Belt South, and the Texas borderlands. These regions were all part of earlier phases of the lasix, which initially spread in rural areas through meatpacking plants, prisons, and nursing buy water pills lasix homes. Counties with large percentages of non-white population also had higher and death rates in earlier phases of the lasix.

Many rural counties in these regions have also been part of a late fall surge, as the lasix has moved from institution-based s to community spread buy water pills lasix. (Popup data is available for all counties, including metropolitan ones, which are shaded gray.) A Deadly December December, the deadliest month on record, accounted for a third of all lasix deaths in 2020. The map shows the percentage of 2020 deaths that occurred in each county in December. In nearly 700 counties, the number of hypertension medications deaths doubled or worse during the buy water pills lasix month.

The December surge deepened the lasix in regions like the Great Plains. In North Dakota, for example, 10 counties doubled their number of deaths or worse in December. Pierce County buy water pills lasix saw its deaths increase from seven to 21 during the month. Renville County grew from two to 12 deaths.

In South Dakota, Hamlin County went from only four deaths to 34 in the month. Grant County grew from 12 buy water pills lasix to 35. Brown County from 21 to 60. Eastern counties were also part of the December surge.

In central Pennsylvania, Jefferson County saw buy water pills lasix a seven-fold increase in deaths in one month, growing from six to 43. Verango County, Pennsylvania, had a six-fold increase, from eight deaths to 47. You Might Also Like.

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€˜None of us will be safe until everyone is lasix for cellulitis safe. Global access to hypertension treatments, tests and treatments for lasix for cellulitis everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hypertension medications vaccination.

The success of a safe and efficacious hypertension medications treatment depends just not only on production and availability but also crucially on uptake.In countries such as the UK where hypertension medications treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become lasix for cellulitis a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite availability of treatment services’)3 is not a single entity. Reasons vary and there is a continuum from complete lasix for cellulitis acceptance to refusal of all treatments, with treatment hesitancy lying between the two poles. Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hypertension medications treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply.

There are genuine knowledge voids (eg, long-term safety data), which in some cases have been filled with lasix for cellulitis misinformation.7 Recent studies have assessed potential acceptance rates specifically for the hypertension medications treatment. A UK study of more than 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this decision lasix for cellulitis as well as beliefs about the likelihood of hypertension medications , the efficacy, speed of development and side effects of the treatment. This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness.

As mental health clinicians, we assessed the impact of mental health conditions on hypertension medications treatment hesitancy and searched for current guidance in this area using a validated approach.9 We found that there is currently no specific guidance in addressing treatment hesitancy in those lasix for cellulitis with mental health difficulties,10 although it is recognised that this is a high-risk group who should be monitored. People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hypertension medications and for more severe complications and higher lasix for cellulitis mortality.11 Historically, the uptake of similar treatments such as the influenza treatment in those with SMI can be as low as 25%,12 and so, similar to other low uptake groups, focused efforts are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems.

In the example of the UK, monitoring of treatment coverage of most lasix for cellulitis routine immunisation programmes relies on data extracted from primary care systems. To monitor lasix for cellulitis vulnerable groups, the data need to be specifically recorded. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules.

In addition, the extent of a particular inequality lasix for cellulitis varies when it intersects with one or more other factors. In the case of mental illness, multiple long-term conditions across lasix for cellulitis mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is so high.15 Therefore, in the context of a hypertension medications treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still have significant health benefits.14Uptake of vaccination is crucial both for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input.

At the moment there is little formal guidance on how to support those with mental health issues to access clear and reliable information, and practical and easy access to lasix for cellulitis vaccination for those who are willing. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

€˜None of us will be safe until buy water pills lasix everyone is safe http://carlfarrugia.com/sell-media-search/. Global access to hypertension buy water pills lasix treatments, tests and treatments for everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hypertension medications vaccination. The success of a safe and efficacious hypertension medications treatment depends just not only on production and availability but also crucially on uptake.In countries such as the UK where hypertension medications treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite availability of treatment services’)3 is not buy water pills lasix a single entity. Reasons vary and there is a continuum from complete acceptance to refusal buy water pills lasix of all treatments, with treatment hesitancy lying between the two poles.

Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hypertension medications treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply. There are genuine knowledge voids (eg, long-term safety data), which buy water pills lasix in some cases have been filled with misinformation.7 Recent studies have assessed potential acceptance rates specifically for the hypertension medications treatment. A UK study of more than 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this decision as well as beliefs about the likelihood of hypertension medications , the efficacy, speed of development and side effects of buy water pills lasix the treatment. This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness. As mental health clinicians, we assessed the impact of mental health conditions on hypertension medications treatment hesitancy buy water pills lasix and searched for current guidance in this area using a validated approach.9 We found that there is currently no specific guidance in addressing treatment hesitancy in those with mental health difficulties,10 although it is recognised that this is a high-risk group who should be monitored.

People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hypertension medications and for more severe complications and higher mortality.11 Historically, the uptake of similar treatments such as the influenza treatment in those with SMI buy water pills lasix can be as low as 25%,12 and so, similar to other low uptake groups, focused efforts are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems. In the example of the UK, monitoring buy water pills lasix of treatment coverage of most routine immunisation programmes relies on data extracted from primary care systems. To monitor vulnerable groups, the data need buy water pills lasix to be specifically recorded. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules.

In addition, the extent of a buy water pills lasix particular inequality varies when it intersects with one or more other factors. In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is so buy water pills lasix high.15 Therefore, in the context of a hypertension medications treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still have significant health benefits.14Uptake of vaccination is crucial both for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input. At the moment there is little formal guidance on how to support those with mental health issues to access clear and reliable information, and practical and easy access to vaccination for buy water pills lasix those who are willing. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

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Increased economic define lasix integration and technological advancements in communication and transportation over the past several decades have spurred growth in http://www.em-kleber-schiltigheim.ac-strasbourg.fr/?p=1370 cross-national investment, migration and cultural exchange. Nations, economies and people are increasingly interconnected and interdependent. Increasingly ‘globalised’ define lasix.

The concept of globalisation entered the mainstream vocabulary in the 1990s, but its history has been fraught with controversy.1 Primarily an economic process involving domestic deregulation, trade liberalisation and privatisation, globalisation can have profound social and cultural ramifications. Proponents highlight the economic benefits and improved standards of living for many communities, while opponents of globalisation focus on the disproportionate channelling of wealth to larger Western nations and the further disempowerment of populations who lack the skills to meaningfully participate in define lasix this flow of information and resources.1Similarly, the globalisation of healthcare has also inspired competing interpretations and perspectives. Historically, the globalisation of health has referred to the cross-border flow of healthcare professionals for employment, patients for medical services and public health and research measures across nations.

These broad categories reflect the challenges in defining define lasix this critical concept that informs social policy, drives change and impacts population health outcomes. More recently, the globalisation of medical education has been used to describe the transnational transfer of curricula, practices and accreditation standards, the global movements of faculty and medical trainees, and the establishment of international branches of medical schools and academic institutions.2 3 The importation of Western-based competencies and educational modalities has sparked discourse around the potential for ‘homogenisation and cultural dominance’ in medical education.2 4 Global accreditation requirements purport to establish standard outcomes and ensure minimum levels of competence, using standardised curricula and accreditation protocols.3 However, globalised medical education may not consistently align with local priorities and needs and has been criticised for imposing Western paradigms on non-dominant nations.2 For example, in India, Western influences predominate medical education, whereby curricula often focus on diseases not relevant to the community.5 In Southeast Asia, student-centred teaching approaches, including problem-based learning, were adopted even though they conflicted with longstanding cultural traditions and norms between students and teachers.6 As such, researchers and educators have expressed concerns that international medical education is overlooking important cultural nuances and is, instead, promoting standards that are Western, rather than truly global.2As medical educators in the Middle East, we have witnessed the effects of globalised medical education. Many students are sponsored by the government to train in medical define lasix schools and residency programmes in North America, Australia and Europe, with little consideration of the alignment between the type and content of training received abroad and the needs of the home country to which they return.

More recently, several Gulf countries have mandated the wide-scale implementation of US-based accreditation frameworks as part of graduate medical education reform efforts.3 7 8 This often translates to medical trainees that are taught by multinational faculty, using Western-based curricula and assessment methods, in fundamentally different sociocultural, economic and regulatory contexts. The question define lasix remains. How do educational systems maintain best practice and outcome standards while remaining responsive to the local needs?.

Over the past decade, educational researchers define lasix worldwide have proposed glocalisation as a potential answer.Glocalisation, a neologism combining the terms globalisation and localisation, describes the adaptation of international standards to local needs and cultures.4 By glocalising curricula, accreditation standards and educational practices, trainees learn to provide global standards of care that address local health priorities. The ultimate goal of the glocalisation of medical education is the advancement of population health outcomes and system responsiveness to local health needs. Glocalisation efforts in the medical education define lasix literature highlight three main themes.

(1) local adaptation of accreditation standards, (2) exploration of educational methodologies towards glocalisation and (3) identification of challenges facing glocalisation efforts. We will define lasix review each of these areas in an attempt to further describe this construct.Much of the globalisation in medical education literature deals with the adoption of accreditation standards. Many countries in Europe, Asia and the Middle East have adopted the competency-based framework of the Royal College of Canada.9 When the US-based Accreditation Council for Graduate Medical Education offered international accreditation services in 2010, several countries rapidly adopted its model and standards.3 Not surprisingly, glocalisation efforts have focused on ensuring local relevance of related standards and processes.

Research has shown that these efforts are diverse and define lasix often require input from multiple stakeholders. For example, Ho et al describe four categories of deviation between global accreditation standards and medical schools attempting to glocalise their local accreditation systems in Taiwan, Japan and South Korea.4 These include structural differences of medical education in the national context (such as programme length, entry requirements and school governance), differences requiring adaptation of standards to conform to local regulatory environments, developmental trajectory differences representing the influence of contextual events on medical education and aspirational differences reflecting local priorities and focuses.4Other attempts to glocalise have focused on educational competencies, rather than accreditation standards. Several authors have questioned the applicability of Western definitions of medical professionalism to define lasix their local contexts.

In this regards, glocalisation efforts towards the development of culturally relevant medical professionalism curricula represent a common area of study.10 For example, in the United Arab Emirates, we implemented a novel methodology towards glocalising medical professionalism, employing several consensus-gathering techniques. The resultant definition identified additional domains to Western definitions of professionalism that incorporated culturally relevant constructs, including spirituality in professional practice and the role of family and community in patient care decisions.10 Many other educational constructs, such as leadership, communication skills and medical ethics, cannot be directly imported from one country to another but require local adaptation.Finally, when considering the process of glocalisation, define lasix studies reveal that educational leaders must give due consideration to the complexity of challenges encountered. These include diverse or conflicting views on educational objectives and scopes, a lack of representation of the diverse perspectives of the local context, a lack of a shared mental model of competence, misalignment of educational requirements and health system factors and the influence of power relationships and decision-makers on the glocalisation process.4 Ensuring diverse representation in glocalisation efforts is critical to fostering consensus, mitigating the challenges identified, facilitating the consideration of contextual factors and leveraging local networks of support.All education is local.

However, for the foreseeable future, healthcare and define lasix health education will be impacted by an increasingly interconnected world. This serves to highlight the critical importance of ensuring that medical education institutions remain accountable to the communities they serve. These seemingly discordant responsibilities are reconciled define lasix through deliberate glocalisation efforts.

If the ultimate goal of medical education is the production of a competent healthcare workforce, equipped with universal practice standards that can meet local population health needs, glocalisation practices must be viewed as essential components of educational standards, and should be adopted by medical educators, accreditation and regulatory bodies and healthcare institutions in the global arena.Ethics statementsPatient consent for publicationNot required.AbstractThe concept of continuity in medical education reflects the progressive professional and personal development that physicians need in education. The aim of this study is investigating the views of the residents about the define lasix adequacy of undergraduate and postgraduate education in the context of preparing them for the next stage and their perceptions about the transition period. This phenomenological study was conducted at Hacettepe University Medical School.

The study group consisted of medical and surgical sciences residents in the first year and last year of define lasix postgraduate medical education. Four focus group interviews were held with the participation of 21 residents. The participants emphasised that practising with define lasix real patients under supervision by taking an active role in healthcare teams was important for their preparation for the next stage in their carrier.

However, their educational experiences during undergraduate medical education differed in community-based education, scientific research training, learning in small groups, internship and guidance of clinical educators. The transition period has been expressed with the concepts of identity change, high define lasix responsibilities and expectations required by the new identity, adaptation to the healthcare team, institution, and health system, meeting the expectations in an overly busy work environment, and feelings of incompetence. Participants pointed out that curriculum, which was declared and taught, educational environments, assessment approaches, consultancy systems and practices differed between the clinical departments.

In line with the principles of competency-based education, practices related to the development and assessment of the competencies define lasix with all professional aspects in postgraduate medical education can be strengthened.Medical education &. Training.

Increased economic integration and technological advancements in communication and transportation over the buy water pills lasix lasix cost walmart past several decades have spurred growth in cross-national investment, migration and cultural exchange. Nations, economies and people are increasingly interconnected and interdependent. Increasingly ‘globalised’ buy water pills lasix. The concept of globalisation entered the mainstream vocabulary in the 1990s, but its history has been fraught with controversy.1 Primarily an economic process involving domestic deregulation, trade liberalisation and privatisation, globalisation can have profound social and cultural ramifications.

Proponents highlight the economic benefits and improved standards of living for many communities, while opponents of globalisation focus buy water pills lasix on the disproportionate channelling of wealth to larger Western nations and the further disempowerment of populations who lack the skills to meaningfully participate in this flow of information and resources.1Similarly, the globalisation of healthcare has also inspired competing interpretations and perspectives. Historically, the globalisation of health has referred to the cross-border flow of healthcare professionals for employment, patients for medical services and public health and research measures across nations. These broad categories reflect the challenges in defining this critical concept that informs social policy, drives change and buy water pills lasix impacts population health outcomes. More recently, the globalisation of medical education has been used to describe the transnational transfer of curricula, practices and accreditation standards, the global movements of faculty and medical trainees, and the establishment of international branches of medical schools and academic institutions.2 3 The importation of Western-based competencies and educational modalities has sparked discourse around the potential for ‘homogenisation and cultural dominance’ in medical education.2 4 Global accreditation requirements purport to establish standard outcomes and ensure minimum levels of competence, using standardised curricula and accreditation protocols.3 However, globalised medical education may not consistently align with local priorities and needs and has been criticised for imposing Western paradigms on non-dominant nations.2 For example, in India, Western influences predominate medical education, whereby curricula often focus on diseases not relevant to the community.5 In Southeast Asia, student-centred teaching approaches, including problem-based learning, were adopted even though they conflicted with longstanding cultural traditions and norms between students and teachers.6 As such, researchers and educators have expressed concerns that international medical education is overlooking important cultural nuances and is, instead, promoting standards that are Western, rather than truly global.2As medical educators in the Middle East, we have witnessed the effects of globalised medical education.

Many students are sponsored by the government to train in medical schools and residency programmes in North America, Australia and Europe, with little consideration of the alignment between the type and content of training received abroad buy water pills lasix and the needs of the home country to which they return. More recently, several Gulf countries have mandated the wide-scale implementation of US-based accreditation frameworks as part of graduate medical education reform efforts.3 7 8 This often translates to medical trainees that are taught by multinational faculty, using Western-based curricula and assessment methods, in fundamentally different sociocultural, economic and regulatory contexts. The question remains buy water pills lasix. How do educational systems maintain best practice and outcome standards while remaining responsive to the local needs?.

Over the past decade, educational researchers worldwide have proposed glocalisation as a potential answer.Glocalisation, a neologism combining the terms globalisation and localisation, describes the adaptation of international standards buy water pills lasix to local needs and cultures.4 By glocalising curricula, accreditation standards and educational practices, trainees learn to provide global standards of care that address local health priorities. The ultimate goal of the glocalisation of medical education is the advancement of population health outcomes and system responsiveness to local health needs. Glocalisation efforts in buy water pills lasix the medical education literature highlight three main themes. (1) local adaptation of accreditation standards, (2) exploration of educational methodologies towards glocalisation and (3) identification of challenges facing glocalisation efforts.

We will review each of these areas in an attempt to further describe this construct.Much of the globalisation in medical education buy water pills lasix literature deals with the adoption of accreditation standards. Many countries in Europe, Asia and the Middle East have adopted the competency-based framework of the Royal College of Canada.9 When the US-based Accreditation Council for Graduate Medical Education offered international accreditation services in 2010, several countries rapidly adopted its model and standards.3 Not surprisingly, glocalisation efforts have focused on ensuring local relevance of related standards and processes. Research has buy water pills lasix shown that these efforts are diverse and often require input from multiple stakeholders. For example, Ho et al describe four categories of deviation between global accreditation standards and medical schools attempting to glocalise their local accreditation systems in Taiwan, Japan and South Korea.4 These include structural differences of medical education in the national context (such as programme length, entry requirements and school governance), differences requiring adaptation of standards to conform to local regulatory environments, developmental trajectory differences representing the influence of contextual events on medical education and aspirational differences reflecting local priorities and focuses.4Other attempts to glocalise have focused on educational competencies, rather than accreditation standards.

Several authors have questioned the applicability of buy water pills lasix Western definitions of medical professionalism to their local contexts. In this regards, glocalisation efforts towards the development of culturally relevant medical professionalism curricula represent a common area of study.10 For example, in the United Arab Emirates, we implemented a novel methodology towards glocalising medical professionalism, employing several consensus-gathering techniques. The resultant definition identified additional domains to Western definitions of professionalism that incorporated culturally relevant constructs, including spirituality in professional practice and the role of family and community in patient care decisions.10 Many other educational constructs, such as leadership, communication skills and medical ethics, cannot be directly imported from one country to another but require local adaptation.Finally, when considering the process of glocalisation, studies reveal that buy water pills lasix educational leaders must give due consideration to the complexity of challenges encountered. These include diverse or conflicting views on educational objectives and scopes, a lack of representation of the diverse perspectives of the local context, a lack of a shared mental model of competence, misalignment of educational requirements and health system factors and the influence of power relationships and decision-makers on the glocalisation process.4 Ensuring diverse representation in glocalisation efforts is critical to fostering consensus, mitigating the challenges identified, facilitating the consideration of contextual factors and leveraging local networks of support.All education is local.

However, for the foreseeable future, healthcare and health education will be impacted by an buy water pills lasix increasingly interconnected world. This serves to highlight the critical importance of ensuring that medical education institutions remain accountable to the communities they serve. These seemingly discordant responsibilities are buy water pills lasix reconciled through deliberate glocalisation efforts. If the ultimate goal of medical education is the production of a competent healthcare workforce, equipped with universal practice standards that can meet local population health needs, glocalisation practices must be viewed as essential components of educational standards, and should be adopted by medical educators, accreditation and regulatory bodies and healthcare institutions in the global arena.Ethics statementsPatient consent for publicationNot required.AbstractThe concept of continuity in medical education reflects the progressive professional and personal development that physicians need in education.

The aim of this study is investigating the views of the buy water pills lasix residents about the adequacy of undergraduate and postgraduate education in the context of preparing them for the next stage and their perceptions about the transition period. This phenomenological study was conducted at Hacettepe University Medical School. The study group consisted of medical and surgical sciences buy water pills lasix residents in the first year and last year of postgraduate medical education. Four focus group interviews were held with the participation of 21 residents.

The participants emphasised that practising with real patients under buy water pills lasix supervision by taking an active role in healthcare teams was important for their preparation for the next stage in their carrier. However, their educational experiences during undergraduate medical education differed in community-based education, scientific research training, learning in small groups, internship and guidance of clinical educators. The transition period has been expressed buy water pills lasix with the concepts of identity change, high responsibilities and expectations required by the new identity, adaptation to the healthcare team, institution, and health system, meeting the expectations in an overly busy work environment, and feelings of incompetence. Participants pointed out that curriculum, which was declared and taught, educational environments, assessment approaches, consultancy systems and practices differed between the clinical departments.

In line with the principles of competency-based buy water pills lasix education, practices related to the development and assessment of the competencies with all professional aspects in postgraduate medical education can be strengthened.Medical education &. Training.

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