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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/28351062/using-national-health-care-databases-and-problem-based-practice-analysis-to-inform-integrated-curriculum-development
#2
Amy J Baker, Mark R Raymond, Steven A Haist, John R Boulet
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350733/using-pas-in-prehospital-environments-to-reduce-ed-and-ems-overuse
#3
Katherine M Thompson, William L Tozier
Emergency medical services (EMS) and EDs in large cities are burdened with a significant number of patients with chronic disease who have limited options for receiving proper care. Despite their relatively small numbers, these "superusers" can have a significant effect on EMS, particularly in large cities. Additionally, EDs are not designed to provide chronic and continuous healthcare. This article describes how several organizations use physician assistants to manage these patients.
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350717/missed-fractures-in-infants-presenting-to-the-emergency-department-with-fussiness
#4
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/28346246/analysis-of-a-patient-intervention-to-reduce-patients-who-leave-without-being-seen-in-an-ophthalmology-dedicated-emergency-room
#5
Alice C Lorch, Maureen Martinez, Matthew Gardiner
Patients who leave without being seen (LWBS) by a medical provider in emergency care settings are a concern because their urgent complaints remain unaddressed. This study aims to characterize the LWBS population in an ophthalmology-dedicated emergency room and to evaluate an intervention designed to decrease the number of these patients. A program of rounding and patient contact in the waiting room of our emergency room was initiated to this end. A patient database was used retrospectively to review 13,124 charts and collect clinical and demographic data on 71 LWBS patients...
March 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28345677/relationships-of-work-related-psychosocial-risks-stress-individual-factors-and-burnout-questionnaire-survey-among-emergency-physicians-and-nurses
#6
Ivana M Ilić, Mirjana Ž Arandjelović, Jovica M Jovanović, Milkica M Nešić
BACKGROUND: Psychosocial risks represent a great challenge for safety and health protection at work in Europe. The purpose of this study has been to determine the relationships of psychosocial risks arising from work, stress, personal characteristics and burnout among physicians and nurses in the Emergency Medical Service (EMS). MATERIAL AND METHODS: We performed a cross-sectional study based on a questionnaire survey which contained the Copenhagen Psychosocial Questionnaire (COPSOQ) and Copenhagen Burnout Inventory (CBI)...
March 24, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28345508/use-of-a-novel-portable-led-based-capillary-refill-time-simulator-within-a-disaster-triage-context
#7
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/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#8
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345187/novel-biomarkers-for-prostate-cancer-an-evidence-based-review-for-use-in-clinical-practice
#9
REVIEW
Vikram M Narayan, Badrinath R Konety, Christopher Warlick
Prostate cancer is a heterogeneous disease with disparate outcomes. Traditional clinical parameters are limited in their ability to differentiate between these cases, and there is uncertainty regarding management strategies. A number of novel biomarkers have emerged, but how best to use them at the point of care remains confusing. In the present review, we describe the most common novel biomarkers, their key supporting literature, and propose a meaningful algorithm for their use in clinical practice. To identify commercially available prostate cancer diagnostic tests, we carried out a PubMed literature search (through May 2016)...
March 27, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28345064/pneumocephalus-in-a-patient-with-multiple-stab-wounds
#10
Yusuf Savran, Volkan Karacam, Basak Bayram, Erdem Yaka, Nuri Karabay
Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344421/impact-of-physician-coordinated-intensive-follow-up-on-long-term-medical-costs-in-patients-with-unstable-angina-undergoing-percutaneous-coronary-intervention
#11
Jing-Jing Jia, Ping-Shuan Dong, Lai-Jing Du, Zhi-Guo Li, Li-Hong Lai, Xu-Ming Yang, Shao-Xin Wang, Xi-Shan Yang, Zhi-Juan Li, Xi-Yan Shang, Xi-Mei Fan
BACKGROUND: To investigate the impact of professional physician-coordinated intensive follow-up on long-term expenditures after percutaneous coronary intervention (PCI) in unstable angina (UA) patients. METHODS: In this study, there were 669 UA patients who underwent successful PCI and followed up for 3 years, then divided into the intensive follow-up group (N = 337), and the usual follow-up group (N = 332). Patients were provided with detailed discharge information and individualized follow-up schedules...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28343817/which-is-better-and-useful-modality-of-x-ray-for-diagnosis-of-pneumothorax-at-emergency-setting-conventional-or-invert-grayscale
#12
Ekrem Musalar, Salih Ekinci, Orkun Ünek, Eda Arş, Hakan Şevki Eren, Bengi Gürses, Can Aktaş
INTRODUCTION: Pneumothorax is a pathologic condition in which air is accumulated between the visceral and parietal pleura. After clinical suspicion, in order to diagnose the severity of the condition, imaging is necessary. By using the help of Picture Archiving and Communication Systems (PACS) direct conventional X-rays are converted to gray-scale and this has become a preferred method among many physicians. METHODS: Our study design was a case-control study with cross-over design study...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343816/the-risk-of-unintentional-out-of-network-encounters-with-hospital-based-physicians-at-in-network-hospitals
#13
Lawrence H Brown, Robert A Weston, John E Gough
OBJECTIVE: When hospital-based specialists including emergency physicians, anesthesiologists, pathologists and radiologists are not included in the same insurance networks as their parent hospitals, it creates confusion and leads to unexpected costs for patients. This study explored the frequency with which hospital-based physicians at academic medical centers are not included in the network directories for the same insurance networks as their parent teaching hospitals. METHODS: We studied teaching hospitals with residency programs in all four hospital-based specialties...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343797/early-brain-edema-is-a-predictor-of-in-hospital-mortality-in-traumatic-brain-injury
#14
Brian Tucker, Jill Aston, Megan Dines, Elena Caraman, Marianne Yacyshyn, Mary McCarthy, James E Olson
BACKGROUND: Identifying patients who may progress to a poor clinical outcome will encourage earlier appropriate therapeutic interventions. Brain edema may contribute to secondary injury in traumatic brain injury (TBI) and thus, may be a useful prognostic indicator. OBJECTIVE: We determined whether the presence of brain edema on the initial computed tomography (CT) scan of TBI patients would predict poor in-hospital outcome. METHODS: We performed a retrospective review of all trauma patients with nonpenetrating head trauma at a Level I Trauma Center...
March 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343186/-profile-of-adults-suffering-from-copd-in-poland
#15
Marcin Nowak, Mateusz Jankowski, Grzegorz M Brożek, Szymon Skoczyński, Patrycja Rzepka-Wrona, Ewa Pierzchała, Jan E Zejda, Władysław Pierzchała
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in adults. It is estimated, that in Poland around two million people suffer from COPD. THE AIM: The aim of this study, was to characterize population of patients with COPD in Poland. MATERIAL AND METHODS: The study, established and coordinated by the Polish Respiratory Society, included a representative sample of 500 GPs where were asked to fill questionnaires on diagnosis and treatment of their COPD patients...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28342622/an-analysis-of-the-relationship-between-burnout-socio-demographic-and-workplace-factors-and-job-satisfaction-among-emergency-department-health-professionals
#16
Menderes Tarcan, Neşet Hikmet, Benjamin Schooley, Mehmet Top, Gamze Yorgancıoglu Tarcan
INTRODUCTION: Burnout among emergency medical practitioners and personnel negatively affects career satisfaction and job performance and can lead to mental health issues, including anxiety, depression, and suicide. PURPOSE: This study investigated the relationship between the perceptions of burnout and job satisfaction of those working in two different hospital's emergency departments assessing the effect of burnout dimensions and additional factors (age, position, marital status, annual income, employment type, gender, patient encounters, and household economic well-being) on job satisfaction...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#17
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#18
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/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#19
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28341587/impact-of-rapid-molecular-respiratory-virus-testing-on-real-time-decision-making-in-a-pediatric-emergency-department
#20
Daniel T Rogan, Mohit S Kochar, Samuel Yang, James V Quinn
Acute respiratory illnesses (ARIs) are usually viral [influenza, respiratory syncytial virus (RSV)] and account for 25% of emergency department (ED) peak-season visits. Laboratory respiratory PCR testing is accurate albeit slow for ED management, whereas rapid antigen testing is inaccurate. We determined the impact of bedside influenza/RSV PCR (molecular point-of-care test; mPOCT) on pediatric ARI management. This was a prospective cohort study of consecutive pediatric patients with ED-ordered respiratory PCR test, enrolled over 9 weeks during peak flu season...
March 21, 2017: Journal of Molecular Diagnostics: JMD
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