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Emergency medicine practice

Luciana Kase Tanno, Ignacio Ansotegui, Pascal Demoly
PURPOSE OF REVIEW: To understand the impact of globalization in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. RECENT FINDINGS: Developments in the field of anaphylaxis have been consistently following these globalization trends offering possibilities of collaborations of the allergy community and integrated international initiatives to reach quality care of allergic patients worldwide. SUMMARY: Globalization is the process of interaction and integration between people, companies, and governments worldwide...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Tyler Sugerman-McGiffin, Gabrielle C Hybki, Jesse Castro, Lisa A Murphy, Colleen Tansey, Jeffrey E Patlogar, Reid K Nakamura, Dillon Y Chen
OBJECTIVE To determine how veterinarians' attire affected clients' perceptions and trust in the small animal emergency medicine setting. DESIGN Cross-sectional study. SAMPLE 154 clients of a 24-hour small animal emergency clinic in a rural location. PROCEDURES A survey was administered to clients in the waiting room over a 1-month period to elicit their impressions of veterinarians' attire in various clinical scenarios and whether that attire would affect their perceptions. Respondents completed the survey after examining photographs of 1 male and 1 female veterinarian in 5 styles of attire (business, professional, surgical, clinical, and smart casual)...
August 1, 2018: Journal of the American Veterinary Medical Association
Michael A Puskarich, Clif Callaway, Robert Silbergleit, Jesse M Pines, Ziad Obermeyer, David W Wright, Renee Y Hsia, Manish N Shah, Andrew A Monte, Alexander T Limkakeng, Zachary F Meisel, Phillip D Levy
For a variety of reasons including cheap computing, widespread adoption of electronic medical records, digitalization of imaging and biosignals, and rapid development of novel technologies, the amount of healthcare data being collected, recorded, and stored is increasing at an exponential rate. Yet despite these advances, methods for the valid, efficient, and ethical utilization of these data remain underdeveloped. Emergency care research, in particular, poses several unique challenges in this rapidly evolving field...
July 18, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
China Scherz
While vernacular therapeutics had long been a topic of interest to many writing about medicine and healing in Africa, with a few exceptions most recent anthropological writings on medicine in Africa are focused on biomedicine. In this article, I trace this shift back to the turn of the millennium and the convergence of three events: the emergence of global health, the accession of the occult economies paradigm, and critiques of culturalism in medical anthropology. I argue that these three shifts led to research projects and priorities that looked different from those defined and undertaken as late as the late 1990s...
July 17, 2018: Medical Anthropology Quarterly
Arlene S Chung, Rachel Felber, Ethan Han, Tina Mathew, Katie Rebillot, Antonios Likourezos
Introduction: Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout...
July 2018: Western Journal of Emergency Medicine
Michael Gottlieb, Andrew King, Richard Byyny, Melissa Parsons, John Bailitz
Journal clubs are an important tool for critically appraising articles and keeping up-to-date with the current literature. This paper provides a critical review of the literature on the design and structure of journal clubs in residency education with a focus on preparation, topic selection, implementation, and integration of technology. Recommendations for preparation include developing clearly defined goals and objectives that are agreed upon by all journal club participants; mentorship from experienced faculty members to ensure appropriate article selection, maintenance of structure, and applicability to objectives; distribution of articles to participants 1-2 weeks prior to the scheduled session with reminders to read the articles at predetermined intervals; and the use of a structured critical appraisal tool for evaluating the articles...
July 2018: Western Journal of Emergency Medicine
Jennifer R Marin, Karen E Thomas, Angela M Mills, Kathy Boutis
Introduction: Given the potential malignancy risks associated with computed tomography (CT), some physicians are increasingly advocating for risk disclosure to patients/families. Our goal was to evaluate the practices and attitudes of pediatric emergency medicine (PEM) fellowship program leaders' regarding CT radiation-risk disclosure. Methods: We conducted a cross-sectional survey study of the United States and Canadian PEM fellowship directors and associate/assistant directors...
July 2018: Western Journal of Emergency Medicine
Derek L Isenberg, Katrina M Kissman, Ellie P Salinski, Mark A Saks, Loreen B Evans
Introduction: In 2013 the Society for Critical Care Medicine (SCCM) published guidelines for the management of pain and agitation in the intensive care unit (ICU). These guidelines recommend using an analgesia-first strategy in mechanically ventilated patients as well as reducing the use of benzodiazepines. Benzodiazepines increase delirium in ICU patients thereby increasing ICU length of stay. We sought to determine whether a simple educational intervention for emergency department (ED) staff, as well as two simple changes in workflow, would improve adherence to the SCCM guidelines...
July 2018: Western Journal of Emergency Medicine
Pilar Garrido, Azucena Aldaz, Miguel Ángel Calleja, Enrique de Álava, María Jesús Lamas, Miguel Martín, Xavier Matías-Guiu, José Palacios, Ruth Vera
Precision medicine is an emerging approach to the prevention and treatment of disease that takes into account variability in genes, environment and lifestyle for each individual. Precision medicine is transforming clinical and biomedical research, as well as health care itself, from a conceptual, as well as a methodological viewpoint, providing extraordinary opportunities to improve public health and lower the costs of the healthcare system. However, the implementation of precision medicine poses ethical-legal, regulatory, organizational and knowledge-related challenges...
July 2018: Revista Española de Patología
Xiukun Wu
Aviation medicine is being recognized as a rising star and an indispensable part of the "trinity" medical emergency network composed of land, water and air. The unparalleled mobility and traffic advantages of aircraft, especially rotorcraft (helicopter), are playing an increasingly important role in rescuing the dying and wounded, especially the critical patients, and thus derive a new medical operation mode. How to adapt to the development of the situation and the progress of the times, give full play to the advantages of aviation medical care? The key factors are improvement of the level of service efficiency, strength of learning, practice courage, innovation, and good at summing up to keep pace with the times...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Jolene Cj Lim, Cerissa Papanastasiou, Katie Moore
OBJECTIVE: Within the complex and dynamic emergency medicine workforce setting, the Australasian College for Emergency Medicine (ACEM) New Fellows (FACEMs) Early Career Survey was established in 2014 to capture information on the work profiles, future career plans and challenges experienced among new FACEMs. METHODS: The voluntary online survey is distributed twice yearly to new FACEMs who gained their Fellowship the preceding 6-12 months. Eligible new FACEMs were contacted by email and invited to participate...
July 15, 2018: Emergency Medicine Australasia: EMA
Brianne McGonigle Leyh, Marie Elske Gispen
Syria is currently experiencing the world's largest humanitarian crisis since World War II, and access to medicines for emergency care, pain control, and palliative care remains shockingly restricted in the country. Addressing the dire need for improved access to medicines in Syria from an international law compliance and accountability perspective, this article highlights four complementary legal frameworks: international human rights law, international drug control law, international humanitarian law, and international criminal law...
June 2018: Health and Human Rights
Esther Coren, Kerry Ramsbotham, Manfred Gschwandtner
BACKGROUND: Research suggests that the number of intellectually disabled people with children is increasing. Intellectual disabilities do not inevitably cause parenting difficulties, but it may impact on an individual's capacity to parent a child effectively. Children of parents with intellectual disabilities may be at increased risk of neglectful care, which could lead to health, developmental and behavioural problems, or increased risk of intellectual disability. Compared with other parents, those with intellectual disabilities are more likely to be involved in care proceedings...
July 13, 2018: Cochrane Database of Systematic Reviews
Vural Özdemir
Globalization and knowledge mobilization (KM) are twin challenges impacting precision medicine currently. Previous KM models have been largely limited to an implementation framework whereby knowledge is imagined as a billiard ball to be simply rolled over from the laboratory to society and from developed to developing countries. This narrow and sanitized understanding of KM and science as being detached from social forces, human values, politics, and power inequities does not help to achieve robust and responsible emergence of precision medicine, not least because tailored medicines are not simple products ready to use off-the-shelf without customization in each country, local context and society...
July 13, 2018: Omics: a Journal of Integrative Biology
Karin Mohn Engebretsen
The search for causal explanations in medically unexplained syndromes such as burnout has not been resolved by evidence-based medicine. A biomedical model encourages a reductionist diagnostic practice and a dualist split between physical and psychological symptoms. Therefore, diagnosing and treating these syndromes remains a challenge. Depression is a common aspect in burnout and, as a result, clinicians often diagnose burnout patients as depressed. The Norwegian government expects medical efficiency to reduce sick leaves...
July 12, 2018: Journal of Evaluation in Clinical Practice
Amelia J Brandt, Bert R Cramer, Shokufeh M Ramirez, Carolyn Johnson
Objectives Despite significant investments in Maternal and Child Health (MCH), the United States still lags behind other countries in key MCH indicators. A well-trained workforce is needed to improve MCH. The Division of MCH Workforce Development of HRSA's Maternal and Child Health Bureau provides funding to schools of Public Health to support Centers of Excellence in MCH, which is focused on preparing the next generation of MCH leaders through specialized training and mentorship. One such center, the Tulane Center of Excellence in MCH (CEMCH), is housed at the Tulane University School of Public Health and Tropical Medicine...
July 12, 2018: Maternal and Child Health Journal
James Love-Koh, Alison Peel, Juan Carlos Rejon-Parilla, Kate Ennis, Rosemary Lovett, Andrea Manca, Anastasia Chalkidou, Hannah Wood, Matthew Taylor
OBJECTIVE: Precision medicine allows healthcare interventions to be tailored to groups of patients based on their disease susceptibility, diagnostic or prognostic information, or treatment response. We analysed what developments are expected in precision medicine over the next decade and considered the implications for health technology assessment (HTA) agencies. METHODS: We performed a pragmatic literature search to account for the large size and wide scope of the precision medicine literature...
July 13, 2018: PharmacoEconomics
Lauri Andress, Danny Scalise, Jessica G Wright, Stephanie E Moore
This study used a focus group in August 2017 (n = 9) to explore the perceptions of rural physicians to a state request to incorporate diabetes prevention screening into their West Virginia medical practice. Analysis of the data revealed that the participants did not think private physicians were equipped to incorporate diabetes prevention programming into their practice. Three categories emerged from the data analysis to explain the reasoning of the health practitioners on the incorporation of pre-diabetes screening and management into their practice...
September 2018: Preventive Medicine Reports
Di Shi, Joseph H Walline, Xuezhong Yu, Jun Xu, Priscilla P Song, Huadong Zhu
Background: To survey the prevalence of bedside ultrasound assessment in emergency departments (EDs) in China. Methods: We designed an online survey for emergency physicians based in the China. The questionnaire included sixteen items querying common ED bedside ultrasound practices. Respondents were recruited via weblinks sent through social media and a popular Chinese emergency medicine website. Survey data was collected from April through June, 2016. Results: Four hundred and twenty-eight physicians responded to this survey; more than 80% of respondents reported working clinically in the ED...
May 2018: Journal of Thoracic Disease
Vaibhav B Katkade, Kafi N Sanders, Kelly H Zou
Evidence from medication use in the real world setting can help to extrapolate and/or augment data obtained in randomized controlled trials and establishes a broad picture of a medication's place in everyday clinical practice. By supplementing and complementing safety and efficacy data obtained in a narrowly defined (and often optimized) patient population in the clinical trial setting, real world evidence (RWE) may provide stakeholders with valuable information about the safety and effectiveness of a medication in large, heterogeneous populations...
2018: Journal of Multidisciplinary Healthcare
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