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Emergency medicine practice

Paul M Lu, Elizabeth E Park, Tracy L Rabin, Jeremy I Schwartz, Lee S Shearer, Eugenia L Siegler, Robert N Peck
BACKGROUND: The prevalence of global health in graduate medical education in the United States (US) has soared over the past two decades. The majority of US internal medicine and pediatric residency programs now offer global health electives abroad. Despite the prevalence of global health electives among US graduate medical programs today, challenges exist that may impact the experience for visiting trainees and/or host institutions. Previous reviews have predominately focused on experiences of undergraduate medical students and have primarily described positive outcomes...
November 5, 2018: Annals of Global Health
Elspeth Cumber, Paul Robert Greig
OBJECTIVES: To determine the feasibility and ease of using a pre-existing health and safety executive fatigue risk calculator to assess doctors' rotas. DESIGN: Observational. SETTING: A large tertiary-referral teaching hospital in the UK. PARTICIPANTS: 95 anonymised foundation years 1 and 2 rotas in General Medicine, General Surgery and Emergency Medicine covering a 4-month period. All rotas provided by rota coordinators were included and assessed...
February 15, 2019: BMJ Open
Geoffrey M Currie
Pharmacology principles provide key understanding that underpins the clinical and research roles of nuclear medicine practitioners. The scope of practice of the nuclear medicine technologist demands knowledge and understanding of indications, contraindications, warnings, precautions, proper use, drug interactions, and adverse reactions for each medication to be used. This article is the sixth in a series of articles that aims to enhance the understanding of pharmacological principles relevant to nuclear medicine...
February 15, 2019: Journal of Nuclear Medicine Technology
Geoffrey M Currie
Pharmacology principles provide key understanding that underpins the clinical and research roles of nuclear medicine practitioners in nuclear cardiology. The scope of practice of the nuclear medicine technologist demands knowledge and understanding of indications, contraindications, warnings, precautions, proper use, drug interactions, and adverse reactions for each medication to be used. This article is the fifth in a series of articles that aims to enhance the understanding of pharmacological principles relevant to nuclear medicine...
February 15, 2019: Journal of Nuclear Medicine Technology
David Li, Kulamakan Kulasegaram, Brian D Hodges
Recently in medicine, the accuracy of machine learning models in predictive tasks has started to meet or exceed that of board certified specialists. The ability to automate cognitive tasks using software has raised new questions about the future role of human physicians in health care. Emerging technologies can displace people from their jobs, forcing them to learn new skills, so it is clear that this looming challenge needs to be addressed by the medical education system. While current medical education seeks to prepare the next generation of physicians for a rapidly evolving health care landscape to meet the needs of the communities they serve, strategic decisions about disruptive technologies should be informed by a deeper investigation of how machine learning will function in the context of medicine...
February 12, 2019: Academic Medicine: Journal of the Association of American Medical Colleges
Jason Gandhi, Min Yea Lee, Gunjan Joshi, Sardar Ali Khan
CONTEXT: Surfer's myelopathy (SM) is an acute syndrome identified by nontraumatic paraparesis or paraplegia. Though traditionally tied to first-time surfers, the condition encompasses any activity involving hyperextension of the back such as gymnastics, yoga, and Pilates. METHODS: MEDLINE® and Google Scholar literature searches were gathered to identify relevant case reports for determining the etiology, pathogenesis, evaluation, and management of SM. RESULTS: While the rare nature of SM limits its full understanding, studies have pinpointed that hyperextension in the back leads to vasculature insufficiency secondary to dynamic compression of the artery of Adamkiewicz...
February 15, 2019: Journal of Spinal Cord Medicine
Daniel DaCosta, Linda J Dodds, Sarah A Corlett
OBJECTIVE: To develop a tool to support medicine-focused person-centred consultations between community pharmacists and stroke survivors. METHOD: Semi-structured interviews with 15 stroke survivors and 16 community pharmacists were conducted. Thematic analysis of the data was performed and emerging themes examined to determine their relevance to the principles of delivering person-centred care. Findings were used to generate a framework from which a consultation tool was created...
February 8, 2019: Patient Education and Counseling
Peter Yao, Sunday Clark, Kriti Gogia, Baria Hafeez, Hanson Hsu, Peter Greenwald
BACKGROUND: Direct-to-consumer telemedicine is becoming part of mainstream medicine, but questions exist regarding the quality of care provided. We assessed antibiotic stewardship, one measure of quality, by comparing antibiotic prescription rates for acute respiratory infections (ARIs) between patients seen by telemedicine and patients seen in-person in two urban emergency departments (EDs). METHODS: In two urban EDs where low-acuity patients in the ED have the option of being seen by telemedicine rather than in-person, we analyzed telemedicine and in-person visits of patients ≥18 years who received ARI diagnoses between July 2016 and September 2017...
February 14, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Alexis Coulourides Kogan, Tony Rosen, Adria Navarro, Diana Homeier, Krithika Chennapan, Laura Mosqueda
BACKGROUND: Standardization in tools and documentation of child abuse and intimate partner violence have proven helpful in completely documenting injuries and suspected abuse among these populations. Similar tools do not yet exist for older adults and elder abuse. OBJECTIVE: To (1) use insights from experts to develop a tool to assist clinicians in appropriately and completely documenting physical findings in injured older adults for potential future forensic investigation of abuse or neglect and (2) to assess the feasibility of incorporating this tool into clinical practice...
February 13, 2019: Journal of General Internal Medicine
Wells Weymouth, Lane Thaut, Nathan Olson
Introduction The use of telemedicine by deployed healthcare providers to improve patient care has been increasing in recent foreign conflicts and humanitarian missions. These efforts have mostly been limited to email consultation with long response lag times. The United States Military has developed several modalities of telemedicine for use in austere environments, ranging from video conferencing, email, and store-and-forward technology. As of now, these efforts have required large pieces of equipment and many technical support personnel and have a delayed response time...
November 30, 2018: Curēus
Jaclyn M Stoffel, Regan A Baum, Adam J Dugan, Abby M Bailey
Purpose: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. Methods: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics...
February 8, 2019: American Journal of Health-system Pharmacy: AJHP
Ahmed Ben Abdelaziz, Asma Ben Abdelaziz, Chokri Zoghlami, Mohamed Khelil, Tarek Barhoumi, Sami Ben Abdelfattah, Kamel Ben Salem
CONTEXT: Following the Tunisian revolution of 2010/2011, a new Public Health literature emerged, by the ministerial departments as well as the civil society, which was marked by the transparency and the comprehensiveness of the approach. OBJECTIVE: To identify the key ideas of the new Tunisian Public Health discourse, reconciling the principles of a globalizing paradigm with the health problems of a country in transition. METHODS: During this qualitative research, a selected series of three Tunisian reports of Public Health, published in the first quinquennium of the revolution, was read by an independent team of experts in Public Health, not having contributed to their elaboration, to identify the consensual foundations of the new Public Health discourse...
October 2018: La Tunisie Médicale
Niloofar Agharezaee, Mehrdad Hashemi, Minoo Shahani, Kambiz Gilany
Precision medicine (PM) is an approach that has the power to create the best effect and safety of medicine and treatment with the least side effects for each person. PM is very helpful as sometimes due to inaccurate or late diagnosis or toxicities of the drugs irreversible side effect for patient's health are generated. This seemingly new and emerging science is also effective in preventing disease, due to differences in the genes, environment, and lifestyles of any particular person. PM can be a prominent criterion in infertility research...
October 2018: Journal of Reproduction & Infertility
Valliappan Muthu, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy T Prasad, Nalini Gupta, Ashutosh N Aggarwal, Ritesh Agarwal
Intrathoracic lymphadenopathy is a common problem encountered in clinical practice and is caused by a wide variety of diseases. Traditionally, the mediastinal lymph nodes were sampled using conventional transbronchial needle aspiration (TBNA), or surgical methods such as mediastinoscopy, and thoracotomy (open or video-assisted thoracoscopy). However, surgical modalities including mediastinoscopy are invasive, expensive, and not universally available. Moreover, they are associated with considerable morbidity and mortality...
January 2019: Journal of Cytology
Femke Nawijn, Wietske H W Ham, Roderick M Houwert, Rolf H H Groenwold, Falco Hietbrink, Diederik P J Smeeing
BACKGROUND: Emergency department utilization has increased tremendously over the past years, which is accompanied by an increased necessity for emergency medicine research to support clinical practice. Important sources of evidence are systematic reviews (SRs) and meta-analyses (MAs), but these can only be informative provided their quality is sufficiently high, which can only be assessed if reporting is adequate. The purpose of this study was to assess the quality of reporting of SRs and MAs in emergency medicine using the PRISMA statement...
February 11, 2019: BMC Emergency Medicine
Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi
Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults...
January 26, 2019: Journal of Integrative Medicine
Inês Branco Soares, Tamara L Imfeld-Isenegger, Urska Nabergoj Makovec, Nejc Horvat, Mitja Kos, Isabell Arnet, Kurt E Hersberger, Filipa A Costa
BACKGROUND: Pharmacist-led cognitive services (PLCS) are increasingly necessary in primary care as a response to patient-centered care. However, the implementation rate and remuneration models of PLCS are either absent or superficially described in the literature. OBJECTIVE: The aim of this study is to review the implementation of PLCS in primary care across Europe and explore the associated third-party paid remuneration models. METHODS: A cross-sectional study was conducted using an online survey sent to representatives of 44 European countries...
February 2, 2019: Research in Social & Administrative Pharmacy: RSAP
Julia Freytag, Fabian Stroben, Wolf E Hautz, Stefan K Schauber, Juliane E Kämmer
BACKGROUND: Training in teamwork behaviour improves technical resuscitation performance. However, its effect on patient outcome is less clear, partly because teamwork behaviour is difficult to measure. Furthermore, it is unknown who should evaluate it. In clinical practice, experts are obliged to participate in resuscitation efforts and are thus unavailable to assess teamwork quality. Consequently, we sought to determine if raters with little clinical experience and experts provide comparable evaluations of teamwork behaviour...
February 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Durga Prasanna Misra, Vikas Agarwal
An emerging trend in the medical literature, including the Rheumatology literature, is that of accumulating large, multicentric, multi-national data based on registries of patients seen in real life situations. Such real-world evidence (RWE) may help provide valuable insights into the long-term outcomes of disease in unselected patients seen in daily practice, including patients belonging to vulnerable populations such as extremes of age, during pregnancy and lactation. Evidences gathered from real life practice settings can help understand drug prescription patterns, including adherence to treatment guidelines, cost-effectiveness of therapy, and real-life long-term outcomes, and adverse effects of treatment with particular medications...
February 6, 2019: Rheumatology International
Elaine Zibrowski, Lisa Shepherd, Richard Booth, Kamran Sedig, Candace Gibson
BACKGROUND: Many emergency departments (EDs) have used the Lean methodology to guide the restructuring of their practice environments and patient care processes. Despite research cautioning that the layout and design of treatment areas can increase patients' vulnerability to privacy breaches, evaluations of Lean interventions have ignored the potential impact of these on patients' informational and physical privacy. If professional regulatory organizations are going to require that nurses and physicians interact with their patients privately and confidentially, we need to examine the degrees to which their practice environment supports them to do so...
February 6, 2019: JMIR Human Factors
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