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Emergency medicine practice

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https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#1
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28724568/bet-2-poor-evidence-on-whether-teaching-cognitive-debiasing-or-cognitive-forcing-strategies-lead-to-a-reduction-in-errors-attributable-to-cognition-in-emergency-medicine-students-or-doctors
#2
Govind Oliver, Gopal Oliver, Rick Body
A short review was carried out to see if teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine. Two relevant papers were found using the described search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. There is currently little evidence that teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine.
August 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28721159/pcsk9-inhibitors-from-discovery-of-a-single-mutation-to-a-groundbreaking-therapy-of-lipid-disorders-in-one-decade
#3
Krzysztof Jaworski, Piotr Jankowski, Dariusz A Kosior
Hypercholesterolemia is one of the main risk factors for coronary heart disease and significantly contributes to the high mortality associated with cardiovascular diseases. Statin therapy represents the gold standard in the reduction of low-density lipoprotein cholesterol concentration. Nevertheless, many patients still cannot achieve the recommended target levels, due to either inadequate effectiveness or intolerance of these drugs. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a promising option in lipid-lowering treatment...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28719482/teaching-incision-and-drainage-perceived-educational-value-of-abscess-models
#4
Cynthia M Adams, Lise E Nigrovic, Gavin Hayes, Peter H Weinstock, Joshua Nagler
OBJECTIVES: Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. METHODS: A combined didactic and practical skills workshop was developed for use at 2 national conferences...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719458/acupuncture-for-chronic-pain-an-update-and-critical-overview
#5
Changshik Yin, Thomas E Buchheit, Jongbae J Park
PURPOSE OF REVIEW: Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain. RECENT FINDINGS: Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28717986/thrombolysis-for-stroke-in-ireland-increasing-access-and-maintaining-safety-in-a-challenging-environment
#6
P McElwaine, J McCormack, C Brennan, H Coetzee, P Cotter, R Doyle, A Hickey, F Horgan, C Loughnane, C Macey, P Marsden, D McCabe, R Mulcahy, I Noone, E Shelley, T Stapleton, D Williams, P Kelly, J Harbison
BACKGROUND: In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. METHOD: Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study...
July 17, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28716793/the-realities-of-partnership-in-person-centred-care-a-qualitative-interview-study-with-patients-and-professionals
#7
Axel Wolf, Lucy Moore, Doris Lydahl, Öncel Naldemirci, Mark Elam, Nicky Britten
OBJECTIVE: Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients' sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice. DESIGN: Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28713447/knowledge-about-blood-borne-pathogens-and-the-prevalence-of-needle-stick-injuries-among-medical-students-in-serbia
#8
Vuk Marusic, Ljiljana Markovic-Denic, Olivera Djuric, Dragana Protic, Emilija Dubljanin-Raspopovic
INTRODUCTION: Medical students are mainly exposed to needle stick and sharp object injuries in the course of their clinical activities during studying. They are at high risk due to their undeveloped skills, restricted clinical experience, lack of knowledge and risk perception. The objectives of this study were to determine the prevalence of needle stick injuries of the fourth and final year medical students, and to estimate their knowledge about blood-borne pathogens disease transmission and standard precautions...
September 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28710228/longitudinal-qualitative-study-describing-family-physicians-experiences-with-attempting-to-integrate-physical-activity-prescriptions-in-their-practice-it-s-not-easy-to-change-habits
#9
Mathieu Bélanger, Emily Wolfe Phillips, Connor O'Rielly, Bertin Mallet, Shane Aubé, Marylène Doucet, Jonathan Couturier, Maxime Mallet, Jessica Martin, Christine Gaudet, Nathalie Murphy, Jennifer Brunet
OBJECTIVE: Physical activity (PA) prescriptions provided by family physicians can promote PA participation among patients, but few physicians regularly write PA prescriptions. The objective of this study was to describe family physicians' experiences of trying to implement written PA prescriptions into their practice. DESIGN: Longitudinal qualitative study where participants were interviewed four times during a 12-month period. After the first interview, they were provided with PA prescription pads...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710054/preliminary-evidence-for-the-emergence-of-a-health-care-online-community-of-practice-using-a-netnographic-framework-for-twitter-hashtag-analytics
#10
Damian Roland, Jesse Spurr, Daniel Cabrera
BACKGROUND: Online communities of practice (oCoPs) may emerge from interactions on social media. These communities offer an open digital space and flat role hierarchy for information sharing and provide a strong group identity, rapid flow of information, content curation, and knowledge translation. To date, there is only a small body of evidence in medicine or health care to verify the existence of an oCoP. OBJECTIVE: We aimed to examine the emergence of an oCoP through the study of social media interactions of the free open access medical education (FOAM) movement...
July 14, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28708418/vaccines-pesticides-and-narratives-of-exposure-and-evidence
#11
Elena Conis
This essay considers the cultural work performed by two public health narratives - the DDT narrative and the vaccine narrative - as they appeared in popular and professional discourse concerning two recent media events: controversy over an antivaccination film, and the emergence of a Zika global public health emergency. Like all narratives in the history of medicine, the stories historians and others tell about DDT and about vaccines organize a shared past to explain the present. They also point to a hoped-for future...
July 14, 2017: Canadian Bulletin of Medical History, Bulletin Canadien D'histoire de la Médecine
https://www.readbyqxmd.com/read/28707287/are-the-origins-of-precision-medicine-found-in-the-corpus-hippocraticum
#12
Meropi K Konstantinidou, Makrina Karaglani, Maria Panagopoulou, Aliki Fiska, Ekaterini Chatzaki
Precision medicine (PM) is currently placed at the center of global attention following decades of research towards the improvement of medical practice. The subject of this study was to examine whether this trend had emerged earlier, in fact if the fundamentals of PM can be traced back to the ancient Greek era. For this reason, we studied the collection of all the Hippocratic texts, called the Corpus Hippocraticum, using original translations, and attempted an interpretation of the ancient authors in the context of the modern concept of PM...
July 13, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28706765/trauma-and-hypothermia-in-antarctica-an-emergency-medicine-marine-simulation-scenario
#13
Chrystal Horwood, Kerry-Lynn Williams, Tate Skinner, Robert Brown, Tia Renouf, Adam Dubrowski
Simulation has been shown to improve both learner knowledge and patient outcomes. Many emergency medicine training programs incorporate simulation into their curricula to provide learners with experiences that are rare to encounter in practice, yet performance with a high degree of competence is critical. One rare encounter, which is depicted in the report, is the management of a trauma patient who was hypothermic after falling from an expedition vessel into the cold Southern Ocean. The unique scenario presented in this technical report incorporates CanMEDS learning objectives including the communicator, health advocate, and collaborator roles...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28704285/cricothyroidotomy-in-situ-simulation-curriculum-cric-study-training-residents-for-rare-procedures
#14
Andrew Petrosoniak, Agnes Ryzynski, Gerald Lebovic, Karen Woolfrey
INTRODUCTION: Technical skill acquisition for rare procedures can be challenging given the few real-life training opportunities. In situ simulation (ISS), a training technique that takes place in the actual workplace, is a promising method to promote environmental fidelity for rare procedures. This study evaluated a simulation-based technical skill curriculum for cricothyroidotomy using deliberate practice, followed by an ISS evaluation session. METHODS: Twenty emergency medicine residents participated in a two-part curriculum to improve cricothryoidotomy performance...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28699480/adulteration-practices-of-psychoactive-illicit-drugs-an-updated-review
#15
Renata Solimini, Maria Concetta Rotolo, Manuela Pellegrini, Adele Minutillo, Roberta Pacifici, Francesco Paolo Busardò, Simona Zaami
BACKGROUND: It is well known that powdery drugs such as cocaine and heroin are frequently adulterated or diluted predominantly to obtain more doses and to increase the drug dealer's profits, but also to enhance, to modify or to oppose drug effects. METHODS: The aim of this report is to provide an overview of the recent scientific literature on medicines as well as on new psychoactive substances, used as cutting agents (i.e. pharmacologically active adulterants) and on the related adverse health effects on consumers, possibly due to the synergistic effect of the adulterants laced with substances of abuse, which represent a matter of great concern because of the frequent fatalities...
July 10, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#16
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire Oâ Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697914/introduction-the-specter-of-opiate-addiction-in-reproductive-medicine
#17
William D Schlaff
The alarming trend in opiate misuse in developed countries is prompting an increasingly strident public call for action. Although many in our field have assumed that this building crisis does not really affect us or our patients, data show that the emerging demographic at highest risk for misusing opiates clearly includes patients who seek care in our practices. The goals of this Views and Reviews are to provide a clear understanding of emerging trends in opiate misuse, to review the impact of opiates on the reproductive axis, and to suggest practical recommendations aimed at both mitigating iatrogenic influences on promoting misuse and developing treatment frameworks when misuse is suspected or identified...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#18
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694036/-priority-setting-and-rationing-of-pharmaceuticals-an-experimental-analysis-of-discussion-processes
#19
Ines Aumann, Svenja Litzkendorf, Kathrin Damm, J Matthias Graf von der Schulenburg
BACKGROUND/OBJECTIVE: In the face of rising expenditure among statutory sickness funds in Germany it is necessary to start a discussion about priority setting in the healthcare system. For a long time this issue was avoided in healthcare debates. As a result, normative directives are still missing, which can lead to priority setting among healthcare providers in daily healthcare practice. A discussion on priority setting can be conducted at three different levels: at the government (macro), the institutional (meso), and the patient (micro) level...
July 7, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28693889/barefoot-doctors-and-the-health-care-revolution-in-rural-china-a-study-centered-on-shandong-province
#20
Sanchun Xu, Danian Hu
Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them...
July 7, 2017: Endeavour
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