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Emergency care practitioner

Kelly M Pennington, Yue Dong, Hongchuan H Coville, Bo Wang, Ognjen Gajic, Diana J Kelm
OBJECTIVE: The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics. DESIGN: The study design was a prospective study evaluating team dynamics before and after remote simulation. SUBJECTS: Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses). SETTING: The study was conducted at nine training sites in eight countries...
December 2018: Medical Education Online
Alfredo Guarino, Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Dario Bruzzese, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar-Lindo, Bhupinder Sandhu, Philip M Sherman, Toshiaki Shimizu
OBJECTIVES: Despite a substantial consistency in recommendations for the management of children with acute gastroenteritis (AGE), a high variability in clinical practice and a high rate of inappropriate medical interventions persist in both developing and developed countries.Aim of this study was to develop a set of clinical recommendations for the management of non-severely malnourished children with AGE to be applied worldwide. METHODS: The Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) Working Group (WG) selected care protocols on the management of acute diarrhea in infants and children aged between 1 month and 18 years...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
Keith A Anderson, Lyn Geboy, Shannon E Jarrott, Lydia Missaelides, Aaron M Ogletree, Lisa Peters-Beumer, Steven H Zarit
Adult day services (ADS) provide care to adults with physical, functional, and/or cognitive limitations in nonresidential, congregate, community-based settings. ADS programs have emerged as a growing and affordable approach within the home and community-based services sector. Although promising, the growth of ADS has been hampered by a lack of uniform outcome measures and data collection protocols. In this article, the authors detail a recent effort by leading researchers and practitioners in ADS to develop a set of uniform outcome measures...
June 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Aisling A Jennings, Tony Foley, Kieran A Walsh, Alice Coffey, John P Browne, Colin P Bradley
OBJECTIVES: To synthesise the existing published literature on general practitioners (GP)'s knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia (BPSD) with a view to informing future interventions. METHODS: We conducted a systematic review and synthesis of quantitative and qualitative studies that explored GPs' experiences of managing BPSD (PROSPERO protocol registration CRD42017054916). Seven electronic databases were searched from inception to October 2017...
June 13, 2018: International Journal of Geriatric Psychiatry
Irini Gergianaki, George Bertsias
Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that manifests a wide range of organ involvement. Traditionally, the diagnosis and management of SLE is provided at secondary and tertiary centers to ensure prompt initiation of treatment, adequate control of flares and prevention of irreversible organ damage. Notwithstanding, the role of primary care in SLE is also emerging as there are still significant unmet needs such as the diagnostic delay at the community level and the high burden of therapy- and disease-related comorbidities...
2018: Frontiers in Medicine
Therese Avallin, Åsa Muntlin Athlin, Erik Elgaard Sorensen, Alison Kitson, Martin Björck, Eva Jangland
AIMS: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. BACKGROUND: Although pain management is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance...
June 12, 2018: Journal of Advanced Nursing
Thomas Frieling
Background: Non-cardiac chest pain (NCCP) is recurrent angina pectoris-like pain without evidence of coronary heart disease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected (in this order) at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life due to NCCP is comparable, and partially even higher, to that caused by cardiac chest pain. Reasons for psychological strain are symptom recurrence in approximately 50%, nonspecific diagnosis with resulting uncertainty, and insufficient integration of other medical disciplines in the diagnostic workup...
April 2018: Visceral Medicine
Catrina Felton-Busch, Sarah Larkins
PROBLEM: Australian Aboriginal women's aspirations for birthing on country (having our babies born on our traditional land) are increasingly being reported in Australian scholarly and policy literature. However given the paucity of publications authored by Aboriginal Australians from remote areas of Australia, how well can the current knowledge base in Australia inform the development of culturally appropriate maternity services for our communities? OBJECTIVE: The aim of this literature review is to critically analyse the policy documents informing maternity services policy and scholarly literature on the birthing experiences (including the provision of maternity services) of Aboriginal Australian women from remote communities from an Indigenous standpoint...
June 7, 2018: Women and Birth: Journal of the Australian College of Midwives
Laserina O'Connor, Bernadette Carpenter, Cora O'Connor, Julie O'Driscoll
BACKGROUND: There is a body of empirical literature indicating that interprofessional education (IPE) not only enriches students' understanding of their own discipline but of other disciplines. However, giving the on-going emphasis on the importance of IPE to healthcare processes and outcomes, on-going attention is needed to advancing the research evidence related to the emergency department setting. The aim of this qualitative descriptive study was to determine the clinical learning experiences of GPs who rotated through an academic urban minor injuries unit as part of their training, led by advanced nurse practitioners (emergency)...
June 7, 2018: International Emergency Nursing
Odd Martin Vallersnes, Dag Jacobsen, Øivind Ekeberg, Mette Brekke
AIMS: Despite the excess mortality and morbidity associated with acute poisoning by substances of abuse, follow-up is frequently not organised. We assessed morbidity, including repeated poisoning, and follow-up after acute poisoning by substances of abuse through charting contacts with health services. We also charted short-term mortality. METHODS: Patients 12 years and older treated for acute poisoning by substances of abuse at a primary care emergency outpatient clinic in Oslo, Norway, were included consecutively from October 2011 through September 2012...
June 1, 2018: Scandinavian Journal of Public Health
S M Wan, B S Liu, X Lu
The Xin'an female doctors in the Ming and Qing Dynasties could be divided into 4 categories: viz., those who provide general medical services for women patients; those who provide supplementary services for delivery women; those who serve as an assistant of their practicing husband; and those who continued to practice medicine after their husband's death. Although the latter two types could be respected by their families and praised by the society, these female medical practitioners were undervalued and overlooked generally in the society where males were the main body of the medical circle and, moreover, they were not well educated, as well as the influence of Confucianist thoughts of "honorable men and humble women" , hence, their deeds were rarely seen in historical records...
January 28, 2018: Zhonghua Yi Shi za Zhi, Chinese Journal of Medical History
Louise Roper, Frances C Sherratt, Bridget Young, Paul McNamara, Angus Dawson, Richard Appleton, Esther Crawley, Lucy Frith, Carrol Gamble, Kerry Woolfall
OBJECTIVES: We explored children's views on research without prior consent (RWPC) and sought to identify ways of involving children in research discussions. DESIGN: Qualitative interview study. SETTING: Participants were recruited through a UK children's hospital and online advertising. PARTICIPANTS: 16 children aged 7-15 years with a diagnosis of asthma (n=14) or anaphylaxis (n=2) with recent (<12 months) experience of emergency care...
June 9, 2018: BMJ Open
M Dalvi Humzah, Saj Ataullah, ChenAn Chiang, Raman Malhotra, Robert Goldberg
BACKGROUND: Visual loss (blindness) caused by injection of soft tissue fillers is a rare but devastating issue to both patient and practitioner. There is a lack of any structured protocol in the management of this problem AIMS: To produce a pathway for the management of hyaluronic acid aesthetic interventional induced visual loss that was based on the current available literature and guidelines. evidence proposed guidance for the practical management of this problem. was evaluated and a pathway has been developed for patient management and specialist advice METHOD: A consensus group experts involved in aesthetic intervention, visual loss research and with experience in dealing with visual loss assessed the current literature and proposed guidelines available...
June 8, 2018: Journal of Cosmetic Dermatology
K A Lockman, W H Lee, R Sinha, W L Teoh, C Bickler, S Dummer, A Veiraiah
Time and resource constraints have often led to the use of assessment records as discharge communications from acute and emergency departments. However, whether this addresses the primary care needs has not been demonstrated. This study examined the optimal structure that can impart key discharge information effectively using feedback from general practitioners (GP). We implemented an electronic assessment template that focused on the most relevant headings. Prespecified process measures were examined and qualitative thematic analysis of free-text comments from GP surveys were conducted to optimise the document...
2018: Acute Medicine
Anna R Hemnes
Pulmonary arterial hypertension (PAH) is a devastating disease for which there is no cure. Presently this condition is differentiated from other diseases of the pulmonary vasculature by a practitioner's history, physical examination, and clinical studies with clinical markers of disease severity primarily guiding therapeutic choices. New technologies such as next generation DNA sequencing, high throughput RNA sequencing, metabolomics and proteomics have greatly enhanced the amount of data that can be studied efficiently in patients with PAH and other rare diseases...
2018: Frontiers in Medicine
Denise Coppa, Suzy Barcelos Winchester, Mary B Roberts
BACKGROUND AND PURPOSE: The purpose of this pilot study was to describe the impact of one aspect of an academic-clinical partnership that showed how assigning nurse practitioner faculty to deliver home-based primary care services to clinically complex patients would decrease rehospitalizations and emergency department visit rates. METHODS: Rehospitalizations and emergency department visits of a cohort of 82 patients were recorded from April 15, 2016 to August 25, 2016 and compared with the same cohort during the two pre-home care inception periods (6 months and 1 year) using insurance claims-based data...
June 2018: Journal of the American Association of Nurse Practitioners
Carola van Dipten, Saskia van Berkel, Wim J C de Grauw, Nynke D Scherpbier-de Haan, Bouke Brongers, Karel van Spaendonck, Jack F M Wetzels, Willem J J Assendelft, Marianne K Dees
BACKGROUND: Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care. METHOD: Qualitative focus group study with 27 GPs in the Netherlands. Three analysts open-coded and comparatively analysed the data...
June 6, 2018: BMC Family Practice
Bonnie J Bereznicki, Madeline Ga Tucker, Sean A Beggs, Graeme R Zosky, Luke Re Bereznicki
AIM: We investigated the presentations of children with unspecified fever to an Australian emergency department (ED): (i) to determine the proportion of these presentations that could be classified as potentially avoidable and (ii) to identify factors associated with an increased risk of hospital admission. METHODS: This study retrospectively identified and described children aged <6 years who presented to the Royal Hobart Hospital (Tasmania, Australia) ED with unspecified fever (ICD-10-AM code R50...
June 6, 2018: Journal of Paediatrics and Child Health
Jennie Bell, Ruth Crawford, Kathy Holloway
INTRODUCTION: New Zealand has a rural population with unique healthcare needs. Traditionally, rural health care has been provided by medical general practitioners (GPs); however, as the number of GPs declines, the rural nurse specialist (RNS) role has emerged. The RNS is a registered nurse with advanced nursing skills that enable independent, autonomous practice within rural areas. The health needs of each rural community are specific to that area and the RNS role has been developed according to local healthcare needs...
June 2018: Rural and Remote Health
Barbara Giannini, Mauro Giacomini
The importance of decision support systems is highly acknowledged as a key strategy to improve medical safety and quality of care. A strong interoperability between the hospital Electronic Health Record (EHR) and the Clinical Decision Support System (CDSS) is the key to reach a most reliable decision support, that could aid in better diagnosis, reduce medication errors and improve practitioner performances. Interoperability is granted by the use of standards for data representation and for system intercommunication...
2018: Studies in Health Technology and Informatics
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