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Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
Marco Helbich, Derek de Beurs, Mei-Po Kwan, Rory C O'Connor, Peter P Groenewegen
Background: Natural outdoor environments, such as green spaces (ie, grass, forests, or parks), blue spaces (ie, visible bodies of fresh or salt water), and coastal proximity, have been increasingly shown to promote mental health. However, little is known about how and the extent to which these natural environments are associated with suicide mortality. Our aim was to investigate whether the availability of green space and blue space within people's living environments and living next to the coast are protective against suicide mortality...
March 2018: Lancet. Planetary Health
E V Aleksandrova, A I Batalov, E L Pogosbekyan, N E Zakharova, L M Fadeeva, A D Kravchuk, I N Pronin, A A Potapov
The study purpose was to develop a technique for intravital visualization of the brainstem reticular formation fibers in healthy volunteers using magnetic resonance imaging (MRI). MATERIAL AND METHODS: The study included 21 subjects (13 males and 8 females) aged 21 to 62 years. The study was performed on a magnetic resonance imaging scanner with a magnetic field strength of 3 T in T1, T2, T2-FLAIR, DWI, and SWI modes. A CSD-HARDI algorithm was used to identify thin intersecting fibers of the reticular formatio...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Carol Cremin, Sarah Howard, Lyly Le, Aly Karsan, David F Schaeffer, Daniel Renouf, Kasmintan A Schrader
Background: Approximately 5% to 10% of pancreatic ductal adenocarcinoma (PDAC) has a hereditary basis. In most of these defined hereditary cancer syndromes, PDAC is not the predominant cancer type. Traditional criteria for publicly funded genetic testing typically require the presence of a set combination of the predominant syndrome-associated cancer types in the family history.We report the identification of a CDKN2A pathogenic variant in a PDAC-prone family without the cutaneous features of multiple moles or melanoma that are characteristic of the Familial Atypical Multiple Mole Melanoma (FAMMM) Syndrome identified in a universal testing algorithm for inherited mutations in pancreatic cancer patients...
2018: Hereditary Cancer in Clinical Practice
Sarah Sims, Mary Leamy, Nigel Davies, Katy Schnitzler, Ros Levenson, Felicity Mayer, Robert Grant, Sally Brearley, Stephen Gourlay, Fiona Ross, Ruth Harris
BACKGROUND: Intentional rounding (IR) is a structured process whereby nurses conduct one to two hourly checks with every patient using a standardised protocol. OBJECTIVE: A realist synthesis of the evidence on IR was undertaken to develop IR programme theories of what works, for whom, in what circumstances and why. METHODS: A three-stage literature search and a stakeholder consultation event was completed. A variety of sources were searched, including AMED, CINAHL, MEDLINE, PsycINFO, HMIC, Google and Google Scholar, for published and unpublished literature...
March 14, 2018: BMJ Quality & Safety
Maxine P Bonham, Gloria K W Leung, Rochelle Davis, Tracey L Sletten, Chiara Murgia, Morag J Young, Nina Eikelis, Elisabeth A Lambert, Catherine E Huggins
INTRODUCTION: Shift work is an independent risk factor for cardiovascular disease (CVD). Shift workers who are awake overnight and sleep during the day are misaligned with their body's endogenous circadian rhythm. Eating at night contributes to this increased risk of CVD by forcing the body to actively break down and process nutrients at night. This pilot study aims to determine whether altering meal timing overnight, in a shift working population, will impact favourably on modifiable risk factors for CVD (postprandial bplasma lipids and glucose concentration)...
March 14, 2018: BMJ Open
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
Kelly A Campen, Katherine M Kucharczyk, Benjamin Bogin, Julie M Ehrlich, Catherine M H Combelles
STUDY QUESTION: What are the effects of exposure to bisphenol A (BPA) or bisphenol S (BPS) during IVM on bovine oocyte maturation, spindle morphology and chromosome alignment? SUMMARY ANSWER: Exposure to BPA or BPS during IVM resulted in increased spindle abnormalities and chromosome misalignment, even at very low concentrations. WHAT IS KNOWN ALREADY: BPA is an endocrine disrupting chemical that alters oocyte maturation, spindle morphology and chromosome alignment in a range of species...
March 12, 2018: Human Reproduction
R van Eekelen, R I Tjon-Kon-Fat, P M M Bossuyt, N van Geloven, M J C Eijkemans, A J Bensdorp, F van der Veen, B W Mol, M van Wely
STUDY QUESTION: What is the natural conception rate over the course of 12 months in couples with unexplained or mild male subfertility who are scheduled for fertility treatment and have a predicted unfavourable prognosis for natural conception? SUMMARY ANSWER: The natural conception rate over the course of 12 months in couples who were allocated to treatment was estimated to be 24.5% (95% CI: 20-29%). WHAT IS KNOWN ALREADY: After starting treatment, couples often perceive unsuccessful cycles as evidence of definitive failure even though they are still able to conceive naturally in between and after treatment...
March 12, 2018: Human Reproduction
Hanh Ngo, Roberto Forero, David Mountain, Daniel Fatovich, Wing Nicola Man, Peter Sprivulis, Mohammed Mohsin, Sam Toloo, Antonio Celenza, Gerard Fitzgerald, Sally McCarthy, Ken Hillman
BACKGROUND: In 2009, the Western Australian (WA) Government introduced the Four-Hour Rule (FHR) program. The policy stated that most patients presenting to Emergency Departments (EDs) were to be seen and either admitted, transferred, or discharged within 4 hours. This study utilised de-identified data from five participating hospitals, before and after FHR implementation, to assess the impact of the FHR on several areas of ED functioning. METHODS: A state (WA) population-based intervention study design, using longitudinal data obtained from administrative health databases via record linkage methodology, and interrupted time series analysis technique...
2018: PloS One
Joseph E Kerschner, Jerris R Hedges, Karen Antman, Edward Abraham, Edgar Colón Negrón, J Larry Jameson
Academic medical center (AMC) faculty, administrators, and leaders have the critical tasks of teaching and training the next generation of health care providers and biomedical researchers, as well as generating new knowledge that improves the health of all. In the United States, medical schools and their affiliated hospitals train remarkably high-quality physicians and scientists, and the research conducted at these institutions results in advances in health. To that end, AMCs have become essential engines for driving better health in the United States and the rest of the world; they also have become essential engines driving the economies of their respective communities and regions...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Jodi Summers Holtrop, Borsika A Rabin, Russell E Glasgow
BACKGROUND: There have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs. Full use of the model includes use of qualitative methods to understand why and how results were obtained on different RE-AIM dimensions, however, recent reviews have revealed that qualitative methods have been used infrequently. Having quantitative and qualitative methods and results iteratively inform each other should enhance understanding and lessons learned...
March 13, 2018: BMC Health Services Research
Michael A Skinnider, David D W Twa, Jordan W Squair, Norman D Rosenblum, Christine D Lukac
CONTEXT: MD/PhD programmes provide structured paths for physician-scientist training. However, considerable proportions of graduates of these programmes do not pursue careers in research consistent with their training. OBJECTIVES: We sought to identify factors associated with sustained involvement in research after completion of all postgraduate training. METHODS: Anonymised data from a national survey of Canadian MD/PhD programme graduates who had completed all physician-scientist training (n = 70) were analysed...
March 13, 2018: Medical Education
Antonia Quinn, Teresa M Chan, Christopher Sampson, Catherine Grossman, Christine Butts, John Casey, Holly Caretta-Weyer, Michael Gottlieb
Traditionally, scholarship that was recognized for promotion and tenure consisted of clinical research, bench research, and grant funding. Recent trends have allowed for differing approaches to scholarship, including digital publication. As increasing numbers of trainees and faculty turn to online educational resources, it is imperative to critically evaluate these resources. This article summarizes five key papers that address the appraisal of digital scholarship and describes their relevance to junior clinician educators and faculty developers...
January 3, 2018: Curēus
Rüdiger M Zimmerer, Nils-Claudius Gellrich, Sophie von Bülow, Edward Bradley Strong, Edward Ellis, Maximilian E H Wagner, Gregorio Sanchez Aniceto, Alexander Schramm, Michael P Grant, Lim Thiam Chye, Alvaro Rivero Calle, Frank Wilde, Daniel Perez, Gido Bittermann, Nicholas R Mahoney, Marta Redondo Alamillos, Joanna Bašić, Marc Metzger, Michael Rasse, Jan Dittman, Elke Rometsch, Kathrin Espinoza, Ronny Hesse, Carl-Peter Cornelius
PURPOSE: Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the influence of plate position and surface contour on clinical outcome has yet been published. MATERIALS AND METHODS: Data from a previous study were used for an ad-hoc analysis to identify predictors for unfavorable outcome, defined as diplopia or differences in globe height and/or globe projection of >2 mm...
February 1, 2018: Journal of Cranio-maxillo-facial Surgery
Tamasin Taylor, Yijiao Wang, William Rogerson, Lynda Bavin, Cindy Sharon, Grant Beban, Nicholas Evennett, Greg Gamble, Timothy Cundy
BACKGROUND: Factors such as ethnicity, gender, and socioeconomic status may play a role in both access to and attrition from bariatric programs before surgery is undertaken. New Zealand (NZ) has high rates of obesity in its Pacific population and the indigenous Māori. These groups also experience poorer health outcomes and therefore have the greatest need for surgery. METHODOLOGY: A retrospective cross-sectional study of 704 people referred for and accepted onto a publicly funded bariatric surgery from 2007 to 2016...
March 10, 2018: Obesity Surgery
Javier Fernández Cotrina, Virginia Iniesta, Isabel Monroy, Victoria Baz, Christophe Hugnet, Francisco Marañon, Mercedes Fabra, Luis Carlos Gómez-Nieto, Carlos Alonso
Canine leishmaniosis is a zoonotic disease caused by Leishmania infantum. Extensive research is currently ongoing to develop safe and effective vaccines to protect from disease development. The European Commission has granted a marketing authorization for LetiFend®, a new vaccine containing recombinant Protein Q. The efficacy of LetiFend® vaccination in a large-scale dog population of both sexes, different breeds and ages in endemic areas is reported in this multicenter, randomized, double-blind, placebo-controlled field trial...
March 7, 2018: Vaccine
Ralph A Saporito, Taran Grant
Amézquita et al. (2017) recently concluded that species of the Allobates femoralis group are toxic to mice at levels equivalent to syntopic alkaloid-containing poison frogs, which they attributed to the presence of alkaloids in skin secretions. However, the chemical composition of skin secretions was not analyzed, and here we present additional data supporting the absence of alkaloids in skin secretions of the Allobates femoralis group. Instead, we suggest the observed toxicity was caused by the anesthetic benzocaine, which was applied to the buccal cavity to euthanize frogs prior to skin removal...
March 10, 2018: Evolution; International Journal of Organic Evolution
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