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https://www.readbyqxmd.com/read/28927448/barriers-and-facilitators-to-implementing-addiction-medicine-fellowships-a-qualitative-study-with-fellows-medical-students-residents-and-preceptors
#1
J Klimas, W Small, K Ahamad, W Cullen, A Mead, L Rieb, E Wood, R McNeil
BACKGROUND: Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships...
September 20, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#2
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28917207/exposure-to-ambient-air-pollution-and-the-incidence-of-dementia-a-population-based-cohort-study
#3
Hong Chen, Jeffrey C Kwong, Ray Copes, Perry Hystad, Aaron van Donkelaar, Karen Tu, Jeffrey R Brook, Mark S Goldberg, Randall V Martin, Brian J Murray, Andrew S Wilton, Alexander Kopp, Richard T Burnett
INTRODUCTION: Emerging studies have implicated air pollution in the neurodegenerative processes. Less is known about the influence of air pollution, especially at the relatively low levels, on developing dementia. We conducted a population-based cohort study in Ontario, Canada, where the concentrations of pollutants are among the lowest in the world, to assess whether air pollution exposure is associated with incident dementia. METHODS: The study population comprised all Ontario residents who, on 1 April 2001, were 55-85years old, Canadian-born, and free of physician-diagnosed dementia (~2...
September 13, 2017: Environment International
https://www.readbyqxmd.com/read/28903578/mental-health-services-use-trends-in-canadian-veterans-a-population-based-retrospective-cohort-study-in-ontario
#4
Alyson L Mahar, Alice B Aiken, Heidi Cramm, Marlo Whitehead, Patti Groome, Paul Kurdyak
OBJECTIVE: A substantial evidence base in the peer-reviewed literature exists investigating mental illness in the military, but relatively less is documented about mental illness in veterans. This study uses provincial, administrative data to study the use of mental health services by Canadian veterans in Ontario. METHOD: This was a retrospective cohort study of Canadian Armed Forces and Royal Canadian Mounted Police veterans who were released between 1990 and 2013 and resided in Ontario...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28902323/hand-hygiene-compliance-of-healthcare-professionals-in-an-emergency-department
#5
Caroline Zottele, Tania Solange Bosi de Souza Magnago, Angela Isabel Dos Santos Dullius, Adriane Cristina Bernat Kolankiewicz, Juliana Dal Ongaro
OBJECTIVE: To analyze compliance with hand hygiene by healthcare professionals in an emergency department unit. METHOD: This is a longitudinal quantitative study developed in 2015 with healthcare professionals from a university hospital in the state of Rio Grande do Sul. Each professional was monitored three times by direct non-participant observation at WHO's five recommended moments in hand hygiene, taking the concepts of opportunity, indication and action into account...
August 28, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28886562/support-of-supervised-injection-facilities-by-emergency-physicians-in-canada
#6
Noam Katz, Lynne Leonard, Lorne Wiesenfeld, Jeffrey J Perry, Venkatesh Thiruganasambandamoorthy, Lisa Calder
BACKGROUND: Despite evidence supporting the implementation of supervised injection facilities (SIFs) by multiple stakeholders, no evaluation of emergency physicians' attitudes has ever been documented towards such facilities in Canada or internationally. The primary goal of our study was to determine the opinions and perceptions of emergency physicians regarding the implementation of SIFs in Canada. METHODS: We conducted a national electronic survey of staff and resident emergency physicians in Canada using an iteratively designed survey tool in consultation with content experts...
September 5, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28877135/want-correct-percentage-of-tbsa-burned-let-a-layman-do-the-assessment
#7
Ilaria Tocco-Tussardi, Benjamin Presman, Fredrik Huss
Accurate determination of burn size significantly impacts both immediate management and long-term outcome. In the era of evidence-based medicine, the variability in TBSA% assessment shown by traditional methods may prove unacceptable and technology-aided systems become the "accepted standard." The objective of this study was to push this scenario to the limit by investigating the accuracy and consistency of TBSA% estimations using a computer-aided tool. Five Laymen (health care-burn management naïve people) were trained on the handling of the technology-aided assessment tool Burn Case 3D and asked to calculate TBSA% for 18 clinical pictures of burns with different patterns and sizes...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28874934/emergency-physician-performed-transesophageal-echocardiography-in-simulated-cardiac-arrest
#8
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28872981/sex-differences-in-outcomes-after-discharge-from-alberta-emergency-departments-for-asthma-a-large-population-based-study
#9
Rhonda J Rosychuk, Maria Ospina, Jingbin Zhang, Richard Leigh, Andrew Cave, Brian H Rowe
OBJECTIVE: Asthma exacerbations frequently result in emergency department (ED) visits. While sex differences have been identified in some asthma studies, there is a paucity of literature on sex differences in the ED setting, especially population-based ones. This study examines sex differences in important outcomes of patients discharged from EDs for acute asthma in Alberta, Canada. METHODS: Alberta residents aged 2 to 55 years discharged from EDs with a primary diagnosis of asthma during 1999- 2011 were identified from administrative databases from a single-payer health care system for the entire geographic region of Alberta...
September 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28870394/variability-in-interpretation-of-cardiac-standstill-among-physician-sonographers
#10
Kevin Hu, Nachi Gupta, Felipe Teran, Turandot Saul, Bret P Nelson, Phillip Andrus
STUDY OBJECTIVE: Cardiac standstill on point-of-care ultrasonography has been widely studied as a marker of prognosis in cardiac arrest. Return of spontaneous circulation has been reported in as few as 0% and as many as 45% of patients with cardiac standstill. When explicitly documented, the definition of cardiac activity in these studies varied from any slight change in echogenicity of the myocardium to any kinetic cardiac activity. We hypothesize that the variability in research definitions of cardiac activity may affect interpretation of video clips of patients in cardiac arrest...
September 1, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28857486/educational-priorities-of-students-in-the-entrustable-professional-activity-era
#11
Roy E Strowd, Allison McBride, Jon Goforth, Joseph Cristiano, Nicholas Hartman, Gregory Waters, James Beardsley, James E Johnson, Kim Askew
BACKGROUND: The Association of American Medical Colleges (AAMC) guidelines on the entrustable professional activities (EPAs) expected of graduating medical students were recently published. Although perceptions of educators, residents and programme directors have been described, the voice of senior medical students is lacking. METHODS: A single-institution cross-sectional study of senior medical students was performed. Student perceptions were collected and compared with: (1) national guidelines (i...
August 30, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28853532/-notes-from-a-six-months-volunteer-mission-as-medical-staff-in-a-district-hospital-in-uganda
#12
Reut Harel, Eitan Miron, Ronen Stoff, Yahel Segal
In December 2014 my husband and I flew for a stay of six months in Uganda. We went there in order to volunteer in the district hospital of Kiboga, one of the most impoverished districts of this poverty stricken country. A district in which over 60% of the population lives off less than a dollar and twenty five cents a day, in which the average life expectancy is 46.7 years (9.1 years lower than the national average expectancy). Kiboga's district hospital serves the 300,000 residents of the district, of whom 20,000 live in the district capital, while the rest are mainly farmers and cattle keepers, scattered in small villages that have limited and weather-dependent access...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28841816/medical-migration-a-qualitative-exploration-of-the-atypical-path-of-japanese-international-medical-graduates
#13
Brian S Heist, Haruka Matsubara Torok
BACKGROUND: International Medical Graduates (IMGs) are commonly understood to move from low to high resource countries with motivations including improved financial situations and cultures of emigration. A presumable exception to the above themes would be the Japanese IMG population. The aim of this study was to develop an understanding of the Japanese IMG experience. METHODS: Using a grounded theory approach, we interviewed 19 Japanese IMGs working in the US and 16 Japanese IMGs working in Japan who had completed US clinical training...
August 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28830288/challenges-of-feedback-provision-in-the-workplace-a-qualitative-study-of-emergency-medicine-residents-and-teachers
#14
Chung-Hsien Chaou, Lynn V Monrouxe, Li-Chun Chang, Shiuan-Ruey Yu, Chip-Jin Ng, Ching-Hsing Lee, Yu-Che Chang
BACKGROUND: Feedback is an effective pedagogical tool in clinical teaching and learning, but is often perceived as unsatisfactory. Little is known about the effect of a busy clinical environment on feedback-giving and -seeking behaviors. This study aims to determine the perceptions and challenges of feedback provision in a busy clinical setting, exemplified by an emergency department (ED). METHODS: A qualitative semi-structured interview study design was employed...
August 22, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28830280/how-physicians-teach-in-the-clinical-setting-the-embedded-roles-of-teaching-and-clinical-care
#15
Yvonne Steinert, Mandeep Basi, Peter Nugus
BACKGROUND: Clinical teaching lies at the heart of medical education. However, few studies have explored the embedded nature of teaching and clinical care. The goal of this study was to examine the process of clinical teaching as it naturally, and spontaneously, unfolds in a broad range of authentic contexts with medical students and residents. METHODS: This focused ethnographic study consisted of 160 hours of participant observation and field interviews with three internal medicine teams...
August 22, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28814584/examining-self-reported-and-biological-stress-and-near-misses-among-emergency-medicine-residents-a-single-centre-cross-sectional-assessment-in-the-usa
#16
Bengt B Arnetz, Philip Lewalski, Judy Arnetz, Karen Breejen, Karin Przyklenk
OBJECTIVES: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. DESIGN: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. SETTING: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#17
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28780533/nursing-home-facebook-reviews-who-has-them-and-how-do-they-relate-to-other-measures-of-quality-and-experience
#18
Jennifer Gaudet Hefele, Yue Li, Lauren Campbell, Adrita Barooah, Joyce Wang
BACKGROUND: The growing use of social media creates opportunities for patients and families to provide feedback and rate individual healthcare providers. Whereas previous studies have examined this emerging trend in hospital and physician settings, little is known about user ratings of nursing homes (NHs) and how these ratings relate to other measures of quality. OBJECTIVE: To examine the relationship between Facebook user-generated NH ratings and other measures of NH satisfaction/experience and quality...
August 5, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28777457/a-novel-low-cost-ultrasound-guided-pericardiocentesis-simulation-model-demonstration-of-feasibility
#19
Ashley Sullivan, Lyudmila Khait, Mark Favot
Pericardiocentesis is a rare life-saving procedure for patients with cardiac tamponade. Due to the infrequency of this procedure, simulation models are often used for training. Commercial models are generally expensive. Proposed homemade models offer a lower-cost alternative but can be labor and time intensive. The purpose of this study was to determine the feasibility of a limited use, low-cost ultrasound-guided pericardiocentesis model as a training tool for emergency physicians. Our model proved to be a practical, easily implemented, and acceptable model for training emergency physicians, including residents and students, in ultrasound-guided pericardiocentesis...
August 4, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28767499/clinician-investigator-training-and-the-need-to-pilot-new-approaches-to-recruiting-and-retaining-this-workforce
#20
Alison K Hall, Sherry L Mills, P Kay Lund
Clinician-investigators, also called physician-scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers...
August 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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