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https://www.readbyqxmd.com/read/28351067/do-medical-students-narrative-representations-of-the-good-doctor-change-over-time-comparing-humanism-essays-from-a-national-contest-in-1999-and-2013
#1
Pooja C Rutberg, Brandy King, Elizabeth Gaufberg, Pamela Brett-MacLean, Perry Dinardo, Richard M Frankel
PURPOSE: To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. METHOD: The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" RESULTS: The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#2
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350717/missed-fractures-in-infants-presenting-to-the-emergency-department-with-fussiness
#3
Jamie S Kondis, Jared Muenzer, Janet D Luhmann
OBJECTIVES: The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. METHODS: This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28346626/preparing-residents-for-teaching-careers-the-faculty-for-tomorrow-resident-workshop
#4
Steven Lin, Paul Gordon
BACKGROUND AND OBJECTIVES: Progress toward growing the primary care workforce is at risk of being derailed by an emerging crisis: a critical shortage of family medicine faculty. In response to the faculty shortage, the Society of Teachers of Family Medicine (STFM) launched a 2-year initiative called "Faculty for Tomorrow" (F4T). The F4T Task Force created a workshop designed to increase residents' interest in, and prepare them for, careers in academic family medicine. We aimed to evaluate the effectiveness of this workshop...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28345508/use-of-a-novel-portable-led-based-capillary-refill-time-simulator-within-a-disaster-triage-context
#5
Todd P Chang, Genevieve Santillanes, Ilene Claudius, Phung K Pham, James Koved, John Cheyne, Marianne Gausche-Hill, Amy H Kaji, Saranya Srinivasan, J Joelle Donofrio, Cynthia Bir
Introduction A simple, portable capillary refill time (CRT) simulator is not commercially available. This device would be useful in mass-casualty simulations with multiple volunteers or mannequins depicting a variety of clinical findings and CRTs. The objective of this study was to develop and evaluate a prototype CRT simulator in a disaster simulation context. METHODS: A CRT prototype simulator was developed by embedding a pressure-sensitive piezo crystal, and a single red light-emitting diode (LED) light was embedded, within a flesh-toned resin...
March 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28345070/are-scoring-systems-sufficient-for-predicting-mortality-due-to-sepsis-in-the-emergency-department
#6
Merve Gunes Ozaydin, Ozlem Guneysel, Fatma Saridogan, Vehbi Ozaydin
OBJECTIVES: Scoring systems have been used to risk stratify in intensive care units (ICU), but not routinely used in emergency departments. The aim of this study was to determine accuracy for predicting mortality in emergency medicine with Sequential Organ Failure Assessment (SOFA), Mortality in ED Sepsis (MEDS) score and Simplified Acute Physiology Score (SAPSII). METHODS: This is a prospective observational study. Patients presenting with evidence of sepsis were all included...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28345067/utility-of-360-degree-assessment-of-residents-in-a-turkish-academic-emergency-medicine-residency-program
#7
Cem Oktay, Yesim Senol, Stephan Rinnert, Yildiray Cete
OBJECTIVES: This study was designed to test a 360-degree assessment tool for four of the emergency medicine resident competencies as outlined by the Council of Residency Directors in Emergency Medicine on patient care, communication skills, professionalism and system based practice in an academic Emergency Department. MATERIAL AND METHODS: Using the competency framework of the American Accreditation Council for Graduate Medical Education, a 57 item-containing assessment tool was created...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344933/precision-medicine-the-golden-gate-for-detection-treatment-and-prevention-of-alzheimer-s-disease
#8
H Hampel, S E O'Bryant, J I Castrillo, C Ritchie, K Rojkova, K Broich, N Benda, R Nisticò, R A Frank, B Dubois, V Escott-Price, S Lista
During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer's disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy...
December 2016: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/28344774/the-dockstore-enabling-modular-community-focused-sharing-of-docker-based-genomics-tools-and-workflows
#9
Brian D O'Connor, Denis Yuen, Vincent Chung, Andrew G Duncan, Xiang Kun Liu, Janice Patricia, Benedict Paten, Lincoln Stein, Vincent Ferretti
As genomic datasets continue to grow, the feasibility of downloading data to a local organization and running analysis on a traditional compute environment is becoming increasingly problematic. Current large-scale projects, such as the ICGC PanCancer Analysis of Whole Genomes (PCAWG), the Data Platform for the U.S. Precision Medicine Initiative, and the NIH Big Data to Knowledge Center for Translational Genomics, are using cloud-based infrastructure to both host and perform analysis across large data sets. In PCAWG, over 5,800 whole human genomes were aligned and variant called across 14 cloud and HPC environments; the processed data was then made available on the cloud for further analysis and sharing...
2017: F1000Research
https://www.readbyqxmd.com/read/28344722/assessment-of-emergency-medicine-residents-a-systematic-review
#10
REVIEW
Isabelle N Colmers-Gray, Kieran Walsh, Teresa M Chan
BACKGROUND: Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. METHODS: We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 - June 2014. MeSH terms included "assessment," "residency," and "emergency medicine." We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28343304/geometry-calibration-between-x-ray-source-and-detector-for-tomosynthesis-with-a-portable-x-ray-system
#11
Kohei Sato, Takashi Ohnishi, Masashi Sekine, Hideaki Haneishi
PURPOSE: Tomosynthesis is attracting attention as a low-dose tomography technology compared with X-ray CT. However, conventional tomosynthesis imaging devices are large and stationary. Furthermore, there is a limitation in the working range of the X-ray source during image acquisition. We have previously proposed the use of a portable X-ray device for tomosynthesis that can be used for ward rounds and emergency medicine. The weight of this device can be reduced by using a flat panel detector (FPD), and flexibility is realized by the free placement of the X-ray source and FPD...
March 25, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28342679/pharmacogenomic-aspects-of-bipolar-disorder-an-update
#12
M Budde, D Degner, J Brockmöller, T G Schulze
The hopes for readily implementable precision medicine are high. For many complex disorders, such as bipolar disorder, these hopes critically hinge on tangible successes in pharmacogenetics of treatment response or susceptibility to adverse events. In this article, we review the current state of pharmacogenomics of bipolar disorder including latest results from candidate genes and genome-wide association studies. The majority of studies focus on response to lithium treatment. Although a host of genes has been studied, hardly any replicated findings have emerged so far...
March 22, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28342466/-challenges-benefits-and-limits-of-high-fidelity-simulation-in-emergency-medicine
#13
Christophe Cullati, Thierry Secheresse
Combining in-situ behaviour and reflexive practice during the debriefing, simulation is a powerful pedagogical tool. It enables a team to co-construct shared knowledge in a context of experiential learning and in a safe and reassuring environment.
March 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28342442/comparison-of-qsofa-and-sirs-for-predicting-adverse-outcomes-of-patients-with-suspicion-of-sepsis-outside-the-intensive-care-unit
#14
Eli J Finkelsztein, Daniel S Jones, Kevin C Ma, Maria A Pabón, Tatiana Delgado, Kiichi Nakahira, John E Arbo, David A Berlin, Edward J Schenck, Augustine M K Choi, Ilias I Siempos
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Task Force recently introduced a new clinical score termed quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) for identification of patients at risk of sepsis outside the intensive care unit (ICU). We attempted to compare the discriminatory capacity of the qSOFA versus the Systemic Inflammatory Response Syndrome (SIRS) score for predicting mortality, ICU-free days, and organ dysfunction-free days in patients with suspicion of infection outside the ICU...
March 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#15
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28342177/career-development-awards-in-emergency-medicine-resources-and-challenges
#16
Bryn E Mumma, Anna Marie Chang, Bory Kea, Megan L Ranney
OBJECTIVES: In the United States, emergency medicine researchers hold proportionately fewer federal career development awards than researchers in other specialties. Others hypothesize this deficit may partly be attributed to lack of mentors, departmental resources, and qualified applicants. Our objectives were to examine the association between departmental and institutional resources and career development awards and to describe the barriers to conducting research and obtaining grants in emergency medicine...
March 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28342096/-emergency-treatment-of-tachycardias
#17
N Deubner, H Greiss, T Neumann
The treatment of symptomatic tachycardia is a key challenge in intensive care medicine and emergency care. Making a quick and authoritative diagnosis on an ECG and applying adequate emergency treatment requires a structured approach to analyzing and treating arrhythmias. This CME article offers a practical categorization of the multitude of tachycardias, with medical and electrical treatment options and ECG examples. Appropriate first- and second-line treatment options are presented for most common tachyarrhythmias...
March 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28342083/classification-of-advanced-stages-of-parkinson-s-disease-translation-into-stratified-treatments
#18
REVIEW
Rejko Krüger, Jochen Klucken, Daniel Weiss, Lars Tönges, Pierre Kolber, Stefan Unterecker, Michael Lorrain, Horst Baas, Thomas Müller, Peter Riederer
Advanced stages of Parkinson's disease (advPD) still impose a challenge in terms of classification and related stage-adapted treatment recommendations. Previous concepts that define advPD by certain milestones of motor disability apparently fall short in addressing the increasingly recognized complexity of motor and non-motor symptoms and do not allow to account for the clinical heterogeneity that require more personalized approaches. Therefore, deep phenotyping approaches are required to characterize the broad-scaled, continuous and multidimensional spectrum of disease-related motor and non-motor symptoms and their progression under real-life conditions...
March 24, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28341796/abstracts-from-international-emergency-medicine-journals
#19
EDITORIAL
Ellen J Weber
Editor's note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.
April 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28341682/the-royal-college-of-emergency-medicine-composite-pain-scale-for-children-level-of-inter-rater-agreement
#20
Ffion James, Rosie Edwards, Nirmal James, Rhian Dyer, Victoria Goodwin
OBJECTIVE: To assess the inter-rater agreement of the Royal College of Emergency Medicine (RCEM) Composite Pain Scale. METHODS: A prospective, observational study of 117 children who presented to the ED with pain due to a limb injury. Pain severity was assessed by the triage nurse, doctor and child (depending on their age) using indicators of the RCEM Composite Pain Scale. This pain scale comprises a modified Wong-Baker FACES Pain Rating Scale (FACES Scale), a Behaviour scale and a numerical rating scale (Ladder)...
March 24, 2017: Emergency Medicine Journal: EMJ
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