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https://www.readbyqxmd.com/read/28637069/-preference-changes-regarding-future-work-area-and-intended-position-among-german-residents-after-four-years-of-residency
#1
Stine Ziegler, Hendrik van den Bussche, Farina Römer, Lea Krause-Solberg, Martin Scherer
Introduction We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Methods Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28634909/categorical-risk-perception-drives-variability-in-antibiotic-prescribing-in-the-emergency-department-a-mixed-methods-observational-study
#2
Eili Y Klein, Elena M Martinez, Larissa May, Mustapha Saheed, Valerie Reyna, David A Broniatowski
BACKGROUND: Adherence to evidence-based antibiotic therapy guidelines for treatment of upper respiratory tract infections (URIs) varies widely among clinicians. Understanding this variability is key for reducing inappropriate prescribing. OBJECTIVE: To measure how emergency department (ED) clinicians' perceptions of antibiotic prescribing risks affect their decision-making. DESIGN: Clinician survey based on fuzzy-trace theory, a theory of medical decision-making, combined with retrospective data on prescribing outcomes for URI/pneumonia visits in two EDs...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28632011/essential-public-health-competencies-for-medical-students-establishing-a-consensus-in-family-medicine
#3
Christopher P Morley, Scott R Rosas, Ranit Mishori, William Jordan, Yumi Shitama Jarris, Family Medicine/Public Health Competencies Work Group, Jacob Prunuske
Phenomenon: The integration of public health (PH) competency training into medical education, and further integration of PH and primary care, has been urged by the U.S. Institute of Medicine. However, PH competencies are numerous, and no consensus exists over which competencies are most important for adoption by current trainees. Our objective was to conduct a group concept mapping exercise with stakeholders identifying the most important and feasible PH skills to incorporate in medical and residency curricula...
March 2, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#4
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28617194/impact-of-online-toxicology-training-on-health-professionals-the-global-educational-toxicology-uniting-project-getup
#5
Anselm Wong, Rais Vohra, Andrew H Dawson, Andrew Stolbach
OBJECTIVE: The Global Educational Toxicology Uniting Project (GETUP), supported by the American College of Medical Toxicology, links countries with and without toxicology services via distance education with the aim to improve education. Due to the lack of toxicology services in some countries there is a knowledge gap in the management of poisonings. We describe our experience with the worldwide delivery of an online introductory toxicology curriculum to emergency doctors and other health professionals treating poisoned patients...
June 15, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28616160/cardiopulmonary-arrest-in-primary-care-clinics-more-holes-than-cheese-a-survey-of-the-knowledge-and-attitudes-of-primary-care-physicians-regarding-resuscitation
#6
Sharon Einav, Oren Wacht, Nechama Kaufman, Eliezer Alkalay
BACKGROUND: Patients experiencing pre-arrest symptoms may first refer to their primary care physician. The study's aim was to determine the likelihood that a patient undergoing out-of-hospital cardiac arrest will receive appropriate resuscitation efforts in a primary care clinic in a country with a directive that clinics maintain resuscitation equipment and physicians undergo periodic resuscitation training. METHODS: An anonymous, 23-question online cross-sectional survey was created and administered to primary care physicians working in community clinics (10/1/2015-5/3/2015)...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28611878/physician-variability-in-management-of-emergency-department-patients-with-chest-pain
#7
Peter B Smulowitz, Orit Barrett, Matthew M Hall, Shamai A Grossman, Edward A Ullman, Victor Novack
INTRODUCTION: Chest pain is a common emergency department (ED) presentation accounting for 8-10 million visits per year in the United States. Physician-level factors such as risk tolerance are predictive of admission rates. The recent advent of accelerated diagnostic pathways and ED observation units may have an impact in reducing variation in admission rates on the individual physician level. METHODS: We conducted a single-institution retrospective observational study of ED patients with a diagnosis of chest pain as determined by diagnostic code from our hospital administrative database...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611876/effectiveness-of-resident-physicians-as-triage-liaison-providers-in-an-academic-emergency-department
#8
Victoria Weston, Sushil K Jain, Michael Gottlieb, Amer Aldeen, Stephanie Gravenor, Michael J Schmidt, Sanjeev Malik
INTRODUCTION: Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. METHODS: This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609331/evaluation-and-impact-of-the-advanced-pediatric-life-support-course-in-the-care-of-pediatric-emergencies-in-spain
#9
Javier Benito, Carlos Luaces-Cubells, Santiago Mintegi, Ignacio Manrique Martínez, Mercedes De la Torre Espí, Concepción Miguez Navarro, Paula Vazquez López, Carmen Campos Calleja, Francesc Ferres Serrat, María Teresa Alonso Salas, Javier González Del Rey
INTRODUCTION: The Advanced Pediatric Life Support (APLS) course was introduced in the training of professionals who care for pediatric emergencies in Spain in 2005. OBJECTIVE: To analyze the impact of the APLS course in the current clinical practice in Spanish PEDs. METHODS: The directors of APLS courses were asked about information regarding the courses given to date, especially on the results of the satisfaction survey completed by students at the end of the course...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28601333/variability-in-ct-imaging-of-blunt-trauma-among-ed-physicians-surgical-residents-and-trauma-surgeons
#10
Melissa K James, Shi-Wen Lee, Jennifer A Minneman, Maureen D Moore, Taylor R Klein, R Jonathan Robitsek, Phillip S Barie, Sebastian D Schubl
BACKGROUND: Trauma triage decisions can be influenced by both knowledge and experience. Consequently, there may be substantial variability in computed tomography (CT) scans desired by emergency medicine physicians, surgical chief residents, and attending trauma surgeons. We quantified this difference and studied the effects of each group's decisions on missed injuries, cost, and radiation exposure. METHODS: All blunt trauma activations at an urban level 1 trauma center were studied over a 6-mo period...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601266/emergency-physician-use-of-cognitive-strategies-to-manage-interruptions
#11
Raj M Ratwani, Allan Fong, Josh S Puthumana, Aaron Z Hettinger
STUDY OBJECTIVE: The purpose of this study is to examine whether emergency physicians use strategies to manage interruptions during clinical work. Interruption management strategies include immediately engaging the interruption by discontinuing the current task and starting the interruption, continuing the current task while engaging the interruption, rejecting the interruption, or delaying the interruption. METHODS: An observational time and motion study was conducted in 3 different urban, academic emergency departments with 18 attending emergency physicians...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28593003/focused-cardiac-ultrasound-focus-by-emergency-medicine-residents-in-patients-with-suspected-cardiovascular-diseases
#12
Davood Farsi, Skokoufeh Hajsadeghi, Mohammad Javad Hajighanbari, Mani Mofidi, Peyman Hafezimoghadam, Mahdi Rezai, Babak Mahshidfar, Samaneh Abiri, Saeed Abbasi
INTRODUCTION: Few studies have assessed the value and accuracy of focused cardiac ultrasound (FOCUS) performed by emergency physicians. The aim of the present study was to evaluate the diagnostic accuracy of FOCUS performed by emergency medicine residents compared to echocardiography performed by a cardiologist in emergency department (ED) patients suspected of cardiovascular disease. METHODS: The research involved a prospective observational cross-sectional study enrolling patients over 18-years old suspected of having cardiovascular disease who required an echocardiograph...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28588960/perspectives-of-host-faculty-and-trainees-on-international-visiting-faculty-to-paediatric-academic-departments-in-east-africa
#13
Christiana M Russ, Lakshmi Ganapathi, Diana Marangu, Melanie Silverman, Edward Kija, Sabrina Bakeera-Kitaka, Ahmed Laving
BACKGROUND: Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits? METHODS: We recruited 36 faculty members and residents from among four paediatric departments in East Africa to participate in semistructured interviews which were audio recorded and transcribed...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28576210/accuracy-of-referral-diagnosis-to-an-emergency-eye-clinic
#14
Jasmin Nari, Larry H Allen, Lulu L C D Bursztyn
OBJECTIVE: To determine the accuracy of diagnosis of ophthalmic problems from health care practitioners such as optometrists, general practitioners, and emergency physicians in and around London, Ontario, Canada. DESIGN: Retrospective review of all referrals to the Ivey Eye Institute emergency eye clinic over a period of 6 months from January to July 2011. PARTICIPANTS: During the study period, there were 1810 patient encounters, including 1134 new referrals...
June 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28575263/breast-cancer-screening-beliefs-among-older-chinese-women-in-chicago-s-chinatown
#15
Melissa A Simon, Laura S Tom, XinQi Dong
Background: Chicago's Chinatown is home to a sizeable community of first-generation Chinese American immigrants. This qualitative study seeks to describe the attitudes toward, and barriers and facilitators of, breast cancer screening among Chinese women in Chicago's Chinatown to inform strategies for future interventions. Methods: We conducted six focus groups among Chinese-speaking adult women aged 45 and older. Focus groups were transcribed, coded, and analyzed for emergent themes...
July 1, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28566122/necrotizing-enterocolitis-classification-and-two-initial-steps-towards-prevention
#16
Sandra Meinich Juhl
The premature infant suffers from immaturity of all organ systems, one of them being the gastrointestinal tract. When the infant is born, the immature gastrointestinal tract is exposed to milk and simultaneously colonized by high densities of bacteria. The combination of milk, microbiota and an immature gut, leaves the infant vulnerable to developing the dreaded intestinal emergency necrotizing enterocolitis (NEC). NEC is often very aggressive and no cure exists, which means that prevention is an utmost important topic to researchers, physicians, parents - and infants...
June 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28562135/a-qualitative-study-of-medical-educators-perspectives-on-remediation-adopting-a-holistic-approach-to-struggling-residents
#17
Sara M Krzyzaniak, Stephen J Wolf, Richard Byyny, Lisa Barker, Bonnie Kaplan, Stephen Wall, Jeannette Guerrasio
INTRODUCTION: During residency, some trainees require the identification and remediation of deficiencies to achieve the knowledge, skills and attitudes necessary for independent practice. Given the limited published frameworks for remediation, we characterize remediation from the perspective of educators and propose a holistic framework to guide the approach to remediation. METHODS: We conducted semistructured focus groups to: explore methods for identifying struggling residents; categorize common domains of struggle; describe personal factors that contribute to difficulties; define remediation interventions and understand what constitutes successful completion...
May 31, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28556857/emergency-health-care-professionals-understanding-of-the-costs-of-care-in-the-emergency-department
#18
Kevin A Hoffman, Michelino Mancini
Background: Efficiency and fiscal responsibility are important to the equal, safe, and effective delivery of care in the emergency department, where all presenting patients must be evaluated for emergent conditions. Health care professionals' understanding of the costs of care is a first step to developing rational approaches for the efficient distribution of the finite resources hospitals and emergency departments have at their disposal to reduce costs to patients and health care systems...
June 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28551890/-the-challenge-of-providing-high-standard-medical-services-in-a-public-hospital
#19
Shay Nathanson, Carlos Gruzman
Kaplan Medical Center (KMC) provides medical services to about 1 million Israeli citizens. The southern plain region is one of the leading areas in terms of population growth in Israel and as a result, the demand for medical services is constantly on the rise. The workload at KMC is tremendous; over 140,000 referrals to the emergency department with a 6% increase each year. Bed occupancy in the internal wards is above 120% on average per year (the highest in Israel) and ambulatory care referrals are rising at an overwhelming pace...
February 2017: Harefuah
https://www.readbyqxmd.com/read/28545752/emergency-department-as-a-first-contact-for-mental-health-problems-in-children-and-youth
#20
Peter J Gill, Natasha Saunders, Sima Gandhi, Alejandro Gonzalez, Paul Kurdyak, Simone Vigod, Astrid Guttmann
OBJECTIVE: To characterize youth who use the emergency department (ED) as a "first contact" for mental health (MH) problems. METHOD: This was a population-based cross-sectional cohort study using linked health and demographic administrative datasets of youth 10 to 24 years of age with an incident MH ED visit from April 1, 2010, to March 31, 2014, in Ontario, Canada. We modeled the association of demographic, clinical, and health service use characteristics with having no prior outpatient MH care in the preceding 2-year period ("first contact") using modified Poisson models...
June 2017: Journal of the American Academy of Child and Adolescent Psychiatry
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