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https://www.readbyqxmd.com/read/29914444/conversion-of-extrinsic-into-intrinsic-motivation-and-computer-based-testing-cbt
#1
Maral Hariri-Akbari, Behjat Shokrvash, Firooz Mahmoodi, Fatemeh Jahanjoo-Aminabad, Behzad Yousefi, Fariba Azabdaftari
BACKGROUND: Because computers are used in many aspects of today's life, it seems necessary to include them in teaching and assessment processes. METHOD: The aims of this cross-sectional study were to construct a multidimensional valid scale, to identify the factors that influenced the nature of student motivation on Computer Based Testing (CBT), to recognize how students self-regulated their activities around CBT, and to describe the efficiency of autonomous versus controlled situations on motivation...
June 19, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29891124/retention-of-cricothyrotomy-skills-by-paramedics-using-a-wire-guided-technique
#2
J A March, M J Kiemeney, J De Guzman, J D Ferguson
INTRODUCTION: Cricothyrotomy may be necessary for airway management when a patient's airway cannot be maintained through standard techniques such as oral airway placement, blind insertion airway device, or endotracheal intubation. Wire-guided cricothyrotomy is one of many techniques used to perform a cricothyrotomy. Although there is some controversy over which cricothyrotomy technique is superior, there is no published data regarding long term retention rates. The purpose of this study is to determine whether ground based paramedics can be taught and are able to retain the skills necessary to successfully perform a wire-guided cricothyrotomy...
May 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29885669/residential-aged-care-residents-and-components-of-end-of-life-care-in-an-australian-hospital
#3
Laurence Jee Peng Leong, Gregory Brian Crawford
BACKGROUND: With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required. METHODS: A retrospective case-note review of hospital records was conducted in Adelaide, Australia...
June 9, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29880624/unexpected-early-complication-of-implantable-cardioverter-defibrillator
#4
Ahmed Abdelhafez, Nancy Wassef, Kai Hogrefe, Mohsin Farooq
A 41-year-old woman was visiting Oxford, where she had a sudden cardiac arrest. Cardiopulmonary resuscitation was started by a bystander until the paramedics arrived, who found her in ventricular fibrillation, and delivered three shocks. After 28 min she had return of spontaneous circulation. Emergency coronary angiography revealed normal coronary arteries. Echocardiography followed by a cardiac MRI showed non-dilated left ventricles with no evidence of late gadolinium enhancement. She had a single-chamber implantable-cardioverter defibrillator (ICD)...
June 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29878282/use-of-the-concept-mapping-in-teaching-during-a-medical-rotation-of-interns-an-exploratory-study
#5
Hamida Kwas, Habib Ghédira
INTRODUCTION: Concept mapping is an excellent learning toolallowing to stimulate active learning.For this reason, the concept mapping is currently used increasingly in the medical and paramedical field. The aim of our study is to determine the contribution of teaching of medical interns by the concept mapping. METHODS: Fourteen students enrolled at the same time in a medical rotation in Pulmonology were recruited for this exploratory study. Interns are divided into two groups (A and B)...
December 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29877762/uk-paramedics-confidence-in-identifying-child-sexual-abuse-a-mixed-methods-investigation
#6
Mike Brady
United Kingdom (UK) paramedics are in a prime position to identify children and young people who are victims or at risk of sexual abuse. Paramedics have access, by phone, or in person, to unprepared homes and communities which other health professionals such as social workers may not. Little research exists however, investigating UK paramedic confidence in identifying child sexual abuse. This mixed-method explanatory sequential investigation used the self-reported confidence levels of 276 UK paramedics to inform the design of seven semi-structured focus groups with 25 UK paramedics from a large ambulance service with operating models similar to all UK services...
June 7, 2018: Journal of Child Sexual Abuse
https://www.readbyqxmd.com/read/29875114/critical-care-transport-of-patients-with-brain-injuries
#7
Rachel Zayas
Critical care transport began in the 1970s as a response to the growing need to be able to transport critically ill and injured patients to tertiary care centers for higher levels of care or specialized treatments. Patients in critical condition now are transported great distances to receive potentially lifesaving treatment and interventions. Modes of critical care transport include ambulances, helicopters, and airplanes. Critical care transport teams consist of highly skilled paramedics, registered nurses, respiratory therapists, nurse practitioners, and physicians...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29873588/catch-and-release-evaluating-the-safety-of-non-fatal-heroin-overdose-management-in-the-out-of-hospital-environment
#8
Nathan C Stam, Jennifer L Pilgrim, Olaf H Drummer, Karen Smith, Dimitri Gerostamoulos
BACKGROUND: The aim of this study was to investigate the safety of the management of non-fatal heroin overdose in the out-of-hospital environment; irrespective of whether or not naloxone had been administered. Heroin toxicity-related deaths as well as heroin intoxication-related traumatic deaths following patient-initiated refusal of transport were investigated. METHODS: Heroin-related deaths in the state of Victoria, Australia between 1 January 2012 and 31 December 2013 were investigated and data linkage to pre-hospital Emergency Medical Services performed, in order to identify whether the death was related to the last episode of care by paramedics...
June 6, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29868158/the-effectiveness-of-sustainable-serial-casting-for-clubfoot-deformity-in-a-low-resource-setting
#9
James Turner, Freddie Quiney, John Cashman, Chris Lavy
Aims: Our aim was to assess the effectiveness of the Malawi Clubfoot Programme and comment on such health care strategies in developing countries. Methods: Medical records of 1069 children attending 29 clinics within Malawi were identified between 2007 and 2013. Due to incomplete recording, only 596 patients had adequate data which could be further analysed. Results: The mean age of presentation was 103 days (range 0-8 years) with a sex distribution of M1...
March 2018: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/29866307/comparing-the-biomechanical-and-psychophysical-demands-imposed-on-paramedics-when-using-manual-and-powered-stretchers
#10
Uma Lad, Nathalie M C W Oomen, Jack P Callaghan, Steven L Fischer
The aim of this investigation was to compare the effect of three different stretchers (two powered and one manual) on the biomechanical and psychophysical demands experienced by paramedics when performing routine stretcher handling activities. Eight experienced paramedics performed stretcher raising, lowering, unloading and loading tasks. Video data of task performance and static force requirements were recorded and input into a posture matching program with a quasi-static linked segment model (3DMatch) to compute peak and cumulative L4/L5 compression and shear forces and shoulder moments during each activity...
July 2018: Applied Ergonomics
https://www.readbyqxmd.com/read/29866213/clinical-adverse-events-in-prehospital-patients-with-st-elevation-myocardial-infarction-transported-to-a-percutaneous-coronary-intervention-centre-by-basic-life-support-paramedics-in-a-rural-region
#11
Sylvain Bussières, François Bégin, Pierre-Alexandre Leblanc, Alain Tanguay, Jean-Michel Paradis, Denise Hébert, Richard Fleet
CLINICIAN'S CAPSULE What is known about the topic? ST-elevation myocardial infarction (STEMI) patients transported by ambulance are at risk for adverse events. What did this study ask? What is the impact of transport time on the occurrence of adverse events in the presence of basic life support paramedics? What did this study find? Transport time is not associated with a higher risk of adverse events. Why does this study matter to clinicians? Largest investigation of adverse events in a Canadian cohort of STEMI patients transported by ambulance...
June 5, 2018: CJEM
https://www.readbyqxmd.com/read/29865891/guideline-adherence-in-acute-coronary-syndromes-between-telemedically-supported-paramedics-and-conventional-on-scene-physician-care-a-longitudinal-pre-post-intervention-cohort-study
#12
Sebastian Bergrath, Michael Müller, Rolf Rossaint, Stefan K Beckers, Diane Uschner, Jörg C Brokmann
Health informatics applications reduce time intervals in acute coronary syndromes, but their impact on guideline adherence is unknown. This pre-post intervention study compared guideline adherence between telemedically supported (n = 101, April 2014-July 2015) and conventional on-scene care (n = 120, January 2014-March 2014) in acute coronary syndrome. A multivariate logistic regression was performed for dependent variables: adverse events 0 versus 0, p = NA; electrocardiogram 101 versus 120, p = NA; acetylic salicylic acid 91 versus 102, p = 0...
June 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29861367/patient-and-clinician-factors-associated-with-prehospital-pain-treatment-and-outcomes-cross-sectional-study
#13
Aloysius Niroshan Siriwardena, Zahid Asghar, Bill Lord, Helen Pocock, Viet-Hai Phung, Theresa Foster, Julia Williams, Helen Snooks
OBJECTIVE: We aimed to identify how patient (age, sex, condition) and paramedic factors (sex, role) affected prehospital analgesic administration and pain alleviation. METHODS: We used a cross-sectional design with a 7-day retrospective sample of adults aged 18 years or over requiring primary emergency transport to hospital, excluding patients with Glasgow Coma Scale below 13, in two UK ambulance services. Multivariate multilevel regression using Stata 14 analysed factors independently associated with analgesic administration and a clinically meaningful reduction in pain (≥2 points on 0-10 numerical verbal pain score [NVPS])...
May 23, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29849522/pressure-guided-surgery-of-compartment-syndrome-of-the-limbs-in-burn-patients
#14
D Boccara, R Lavocat, S Soussi, M Legrand, M Chaouat, A Mebazaa, M Mimoun, A Blet, K Serror
Compartment syndrome is a serious complication of high voltage electrical burns, limb carbonization and deep circular burns with delayed escharotomy. Without treatment, ischemic tissue damage leads to irreversible necrosis. Treatment is emergency surgical decompression. The burned patient is usually not searchable and cannot always be readily examined because of bulky dressings; diagnosis of compartment syndrome is always hard to make. The pressure transducer used in central arterial catheters is easy available...
September 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29845604/out-of-hospital-cardiac-arrests-in-nursing-homes-and-primary-care-facilities-in-pirkanmaa-finland
#15
H Kangasniemi, P Setälä, H Huhtala, A Kämäräinen, I Virkkunen, E Jämsen, A Yli-Hankala, S Hoppu
BACKGROUND: Dispatching Emergency Medical Services to treat patients with deteriorating health in nursing homes and primary care facilities is common in Finland. We examined the cardiac arrest patients to describe this phenomenon. We had a special interest in patients for whom cardiopulmonary resuscitation was considered futile. METHODS: We conducted an observational study between 1 June 2013 and 31 May 2014 in the Pirkanmaa area. We included cases in which Emergency Medical Services participated in the treatment of cardiac arrest patients in nursing homes and primary care facilities...
May 29, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29807936/evaluation-of-a-community-paramedicine-health-promotion-and-lifestyle-risk-assessment-program-for-older-adults-who-live-in-social-housing-a-cluster-randomized-trial
#16
Gina Agarwal, Ricardo Angeles, Melissa Pirrie, Brent McLeod, Francine Marzanek, Jenna Parascandalo, Lehana Thabane
BACKGROUND: Low-income older adults who live in subsidized housing have higher mortality and morbidity. We aimed to determine if a community paramedicine program - in which paramedics provide health care services outside of the traditional emergency response - reduced the number of ambulance calls to subsidized housing for older adults. METHODS: We conducted an open-label pragmatic cluster-randomized controlled trial (RCT) with parallel intervention and control groups in subsidized apartment buildings for older adults...
May 28, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29805778/dissociative-symptoms-mediate-the-relation-between-ptsd-symptoms-and-functional-impairment-in-a-sample-of-military-members-veterans-and-first-responders-with-ptsd
#17
Jenna E Boyd, Alina Protopopescu, Charlene O'Connor, Richard W J Neufeld, Rakesh Jetly, Heather K Hood, Ruth A Lanius, Margaret C McKinnon
Background : Posttraumatic Stress Disorder (PTSD) is associated with significant functional impairment in important areas, including interpersonal relationships and occupational or educational roles. Preliminary evidence suggests that the dissociative subtype of PTSD (PTSD+DS), characterized by marked symptoms of depersonalization and derealization, is associated with increased functional impairment and disease severity, including among military members and veterans diagnosed with PTSD. Similarly, first responders (e...
2018: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/29802441/-sepsis-detection-in-emergency-medicine-results-of-an-interprofessional-survey-on-sepsis-detection-in-prehospital-emergency-medicine-and-emergency-departments
#18
C Metelmann, B Metelmann, C Scheer, M Gründling, B Henkel, K Hahnenkamp, P Brinkrolf
BACKGROUND: Sepsis is associated with a high mortality, which can be reduced by starting screening, diagnostics and treatment as early as possible. Due to multiple educational programs and increased awareness, a decreased sepsis mortality on intensive care units has been achieved. Many patients with sepsis are admitted by the prehospital emergency service to hospital emergency departments. Thus, prehospital emergency services and emergency departments provide an opportunity to start screening, diagnosis and treatment earlier...
May 25, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29801960/police-custody-in-the-north-of-england-findings-from-a-health-needs-assessment-in-durham-and-darlington
#19
Charlie Brooker, Karen Tocque, Damian Mitchell, Malcolm Pearce
AIMS: To report on a health needs assessment undertaken in the Durham Constabulary (England) in 2013. METHODOLOGY: The health needs assessment employed a variety of methods: analysis of arrest and healthcare data over a one year period; semi-structured interviews with the police and healthcare staff; and a survey of detainees' view of healthcare. MAIN FINDINGS: The main finding was that the healthcare provider to custody in Durham was delivering an appropriate multi-professional team of nurse, paramedics and forensic medical examiners that was responsive, trusted by the police and which gave detainee's few concerns...
July 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29801955/confidentiality-consent-in-police-custody-general-principles
#20
Jason Payne-James
The care of detainees (prisoners) in police custody has had much focus in recent years. The nature of the role of the doctor or other healthcare professionals within the police custodial setting may often be subject to conflicts, but their respective duties as healthcare professionals should generally overide any police or forensic issue that may be relevant. The laws or rules or statute that govern doctor, nurse or paramedic practice may vary from country to country, but the broad principles of healthcare ethics are universal and have been formulated not only by national healthcare regulatory bodies but by international organizations such as the World Medical Association...
July 2018: Journal of Forensic and Legal Medicine
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