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Sint Maarten, Netherlands Antilles

The American University of the Caribbean School of Medicine is an international, for-profit, U.S. curriculum-based medical school with a main basic science campus in Sint Maarten, and is based in Coral Gables, Florida. Owned by DeVry Inc. since 2011, AUC is fully accredited by the Accreditation Commission on Colleges of Medicine , meets the requirements of the federally guaranteed student loan program, and is therefore approved for participation in the Federal Family Education Loan Program and other federal financial aid programs. The United States Department of Education has determined that the commission’s accreditation standards are comparable to those applicable to U.S. medical schools. Wikipedia.

Upadhyay D.K.,Universiti Sains Malaysia | Mohamed Ibrahim M.I.,Qatar University | Mishra P.,American University of the Caribbean - School of Medicine
BMC Health Services Research | Year: 2015

Background: Patient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided. Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients' satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal. Methods: An interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient's satisfaction scores at baseline, three, six, nine and, twelve months' follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p &0.05). Results: There were significant (p < 0.001) improvements in patients' satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p <0.001) and (p < 0.001), 6-months (p = 0.010), (p<0.001) and (p<0.001), 9-months (p<0.001), (p<0.001) and (p<0.001) and, 12-months (p<0.001), (p<0.001) and (p<0.001) follow-ups respectively. Conclusion: Pharmaceutical care intervention significantly improved the satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients' related outcomes and their level of satisfaction but also improve the healthcare system. © 2015 Upadhyay et al.; licensee BioMed Central. Source

Kinning A.J.,American University of the Caribbean - School of Medicine | Kinning A.J.,Michigan Vascular Center | Becker R.W.,Michigan Vascular Center | Fortin G.J.,Michigan Vascular Center | And 2 more authors.
Journal of Vascular Surgery | Year: 2013

Objective: Currently, no formal practice guidelines exist regarding the use of endografts to exclude hemodialysis access pseudoaneurysms and prolong access lifespan in dialysis patients. We evaluated the efficacy of percutaneous endograft placement for exclusion of hemodialysis access pseudoaneurysms. Methods: Between July 2005 and October 2009, 32 patients were prospectively evaluated. Twenty-four patients were actively enrolled in the study based upon clinical and ultrasonographic evaluation of their hemodialysis accesses. Self-expanding covered endografts were placed percutaneously to exclude access pseudoaneurysms. Patients were evaluated at 2 and 6 months to assess for graft patency, access or outflow stenosis, endoleak, or stent graft migration. Results: No procedural complications resulted from these interventions. An average of 1.8 endografts was placed per patient, with patients requiring between 1 and 3 endografts to exclude pseudoaneurysms. Primary-assisted patency was 83% at completed 2-month follow-up and 54% at 6-month follow-up. At 12 months, primary-assisted patency was 50%. Eleven patients left the study before 6-month follow-up: five (21%) required explantation secondary to infection between 1 and 4 months; three (13%) were lost to follow-up; two (8%) died of unrelated causes; and 1 requested explantation citing pain from the "stent poking the vein." Mean time to explantation secondary to infection was 2.4 months. Mean duration of patency was 17.6 months with a range from 0 to 76 months. Mean duration of patency for patients who completed 6-month follow-up was 28.7 months. The longest duration of patency is 6 years 4 months, after stent fracture and subsequent placement of a new stent at 6 years 2 months. One other incident of stent fracture occurred at 36 months. Dialysis patterns were not interrupted in either patient. Conclusions: The long-term results demonstrate that endograft salvage of failing hemodialysis accesses is a viable and safe alternative to open surgical revision that excludes pseudoaneurysms while maintaining uninterrupted access patency. A larger sample size and longer follow-up are needed to support the study data. © 2013 Society for Vascular Surgery. Source

Pontell M.E.,St. Georges University | Scali F.,American University of the Caribbean - School of Medicine | Enix D.E.,Logan Research | Battaglia P.J.,Logan Research | Marshall E.,St. Georges University
Annals of Anatomy | Year: 2013

This study was designed to examine the anatomical relationship between the obliquus capitis inferior (OCI) muscle and the cervical dura mater at the histological level. Eight human cadavers, with an average age of 65 ± 7.9 years were selected from a convenience sample for suboccipital dissection. Twelve OCI muscle specimens were excised, 100% of which emitted grossly visible soft tissue tracts that inserted into the posterolateral aspect of the cervical dura. These 12 myodural specimens were excised as single, continuous structures and sent for H&E staining. One sample also underwent immuno-peroxidase staining. Microscopic evaluation confirmed a connective tissue bridge emanating from the OCI muscular body and attaching to the posterolateral aspect of the cervical dura mater in 75% of the specimens. Microtome slices of the remaining 25% were not able to capture muscle, connective tissue and dura within the same plane and were therefore unable to be properly analyzed. The sample sent for neuro-analysis stained positively for several neuronal fascicles traveling within, and passing through the OCI myodural bridge. This study histologically confirms the presence of a connective tissue bridge that links the OCI muscle to the dura mater and the presence of neuronal tissue within this connection warrants further examination. This structure may represent a component of normal human anatomy. In addition to its hypothetical role in human homeostasis, it may contribute to certain neuropathological conditions, as well. © 2013 Elsevier GmbH. Source

Hutchins F.T.,Bellarmine University | Brown L.D.,American University of the Caribbean - School of Medicine | Poulsen K.P.,Oregon State University
Academic Medicine | Year: 2014

International immersion experiences do not, in themselves, provide students with the opportunity to develop cultural competence. However, using an anthropological lens to educate students allows them to learn how to negotiate cultural differences by removing their own cultural filters and seeing events through the eyes of those who are culturally different. Faculty at the University of Wisconsin-Madison's Global Health Institute believed that an embedded experience, in which students engaged with local communities, would encourage them to adopt this Cultural Competency 2.0 position. With this goal in mind, they started the Field School for the Study of Language, Culture, and Community Health in Ecuador in 2003 to teach cultural competency to medical, veterinary, pharmacy, and nursing students. The program was rooted in medical anthropology and embraced the One Health initiative, which is a collaborative effort of multiple disciplines working locally, nationally, and globally to obtain optimal health for people, animals, and the environment.In this article, the authors identify effective practices and challenges for using a biocultural approach to educating students. In a semester-long preparatory class, students study the Spanish language, region-specific topics, and community engagement principles. While in Ecuador for five weeks, students apply their knowledge during community visits that involve homestays and service learning projects, for which they partner with local communities to meet their health needs. This combination of language and anthropological course work and community-based service learning has led to positive outcomes for the local communities as well as professional development for students and faculty. Source

Scali F.,American University of the Caribbean - School of Medicine | Pontell M.E.,St. Georges University | Enix D.E.,Logan Research | Marshall E.,St. Georges University
Spine Journal | Year: 2013

Background context: In recent literature, a soft-tissue communication between the rectus capitis posterior major (RCPma) muscle and the cervical dura mater has been identified. To the best of our knowledge, this communication has yet to be validated from a histological perspective nor has it been examined for neural tissue. Purpose: The purpose of this study was to examine the composition and true continuity of the communication between the RCPma and the dura mater at a microscopic level. The communication was also inspected for the presence of proprioceptive neurons. Study design: An anatomical and histological analysis of a novel structure in the atlantoaxial interspace. Methods: Gross dissection was performed on 11 cadavers to remove the RCPma, the soft-tissue communication, and a section of posterior cervical dura mater as one continuous unit. Paraffin embedding and sectioning followed by hematoxylin and eosin staining was conducted to validate the connection. Staining with antineurofilament protein fluorescent antibodies was performed to identify proprioceptive neural tissue on one specimen, and all findings were recorded via photographic documentation. Results: Histological investigation revealed a tendinous matrix inserting into both the RCPma and the posterior aspect of the cervical dura mater in all 11 specimens. In the one specimen examined for neural tissue, antineurofilament protein fluorescence revealed proprioceptive neurons within the communication. Immunoperoxidase staining demonstrated the insertion of these neurons into both the dura mater and the belly of the RCPma. Conclusions: The existence of a true connection between the RCPma and the cervical dura mater provides new insight in understanding the complex anatomy of the atlantoaxial interspace. The presence of a neural component within this connection suggests that it may serve another function aside from simply anchoring this muscle to the dura mater. Such a connection may be involved in monitoring dural tension and may also play a role in certain cervicogenic pathologies. This study also supports previous reports that no true membrane joins the posterior arch of the atlas to the laminae of the axis and contradicts the conventional belief that the ligamentum flavum joins these two structures. © 2013 Elsevier Inc. All rights reserved. Source

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