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Emergency Medicine Service

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https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#1
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29136247/behavioral-mental-health-an-emerging-field-of-service-or-an-oxymoron
#2
Christopher G Hudson
Proliferation in the use of the terminology around behavioral mental health suggests, on one hand, an emerging field of service that integrates psychiatric, substance abuse, and related services. On the other hand, this development also raises questions about the coherence of this approach. This review explores the history, definitional issues, current trends, and available data on the impact of this field. It considers a variety of critiques of behavioral mental health, such as possibility that the field attempts to integrate fundamentally incompatible domains, that the term "behavioral mental health" is thus an oxymoron, and that it represents a co-optation by the insurance industry of traditional ideals of mental health and of behavioral medicine or as code for the implementation of a medical model that emphasizes short-term, behavioral, and psychopharmacological treatments at the expense of a truly biopsychosocial orientation...
November 9, 2017: Social Work
https://www.readbyqxmd.com/read/29132361/the-impacts-of-implementation-of-national-essential-medicines-policies-on-primary-healthcare-institutions-a-cross-sectional-study-in-china
#3
Zhigang Guo, Xiaodong Guan, Luwen Shi
BACKGROUND: In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. METHODS: The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29123350/evaluation-of-community-based-palliative-care-services-perspectives-from-various-stakeholders
#4
Venugopal Vinayagamoorthy, Elayaperumal Suguna, Amol R Dongre
Background: As a part of Memorandum of Understanding with Tamil Nadu Institute of Palliative Medicine, community-based palliative care services have been initiated 2 years back in our urban field practice areas. Aim: The aim of this study was to evaluate the home care service, a major component of our community-based palliative care, with a view to identify the unmet needs of the services rendered for decision-making about the program. Materials and Methods: It was a descriptive qualitative design carried out by the authors trained in qualitative research methods...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29101775/outpatient-satisfaction-with-osteopathic-manipulative-treatment-in-a-hospital-center-a-survey
#5
Marco Tramontano, Alex Martino Cinnera, Marco Petracca, Angela Gaeta, Federica Tamburella, Maurice Audouard, Carlo Caltagirone
Context • Although osteopathy is not yet certified as a health profession in Italy, many people choose osteopathic manipulative treatment (OMT) for pain relief. Nevertheless, no study evaluating patients' degree of satisfaction after OMT and the perceived quality of the treatment has occurred in Italy. Objectives • The study intended to assess outpatients' satisfaction with OMT carried out at a hospital. Design • The research team conducted a survey from January 2015 to January 2016 using 3 questionnaires...
October 28, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29098043/relationship-between-canadian-medical-school-student-career-interest-in-emergency-medicine-and-postgraduate-training-disposition
#6
Riyad B Abu-Laban, Ian M Scott, Margot C Gowans
Background: Canada has two independent routes of emergency medicine (EM) training and certification. This unique situation may encourage medical students with EM career aspirations to apply to family medicine (FM) residencies to subsequently acquire College of Family Physicians of Canada (CFPC) training and certification in EM. We sought answers to the following: 1) Are medical students who indicate EM as their top career choice on medical school entry, and then complete a FM residency, more likely to undertake subsequent CFPC-EM training than other FM residents who did not indicate EM as their top career choice; and 2) What are the characteristics of medical students in four predefined groups, based upon their early interest in EM as a career and ultimate postgraduate training disposition...
June 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29095899/a-systematic-review-of-emergency-department-based-hiv-testing-and-linkage-to-care-initiatives-in-low-resource-settings
#7
Bhakti Hansoti, Gabor D Kelen, Thomas C Quinn, Madeleine M Whalen, Taylor T DesRosiers, Steven J Reynolds, Andrew Redd, Richard E Rothman
INTRODUCTION: Only 45% of people currently living with HIV infection in sub-Saharan Africa are aware of their HIV status. Unmet testing needs may be addressed by utilizing the Emergency Department (ED) as an innovative testing venue in low and middle-income countries (LMICs). The purpose of this review is to examine the burden of HIV infection described in EDs in LMICs, with a focus on summarizing the implementation of various ED-based HIV testing strategies. METHODOLOGY AND RESULTS: We performed a systematic review of Pubmed, Embase, Scopus, Web of Science and the Cochrane Library on June 12, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/29095057/high-inpatient-utilization-among-veterans-health-administration-patients-with-substance-use-disorders-and-co-occurring-mental-health-conditions
#8
Janelle M Painter, Carol A Malte, Anna D Rubinsky, Timothy R Campellone, Amanda K Gilmore, John S Baer, Eric J Hawkins
BACKGROUND: Substance-use disorders (SUDs) are common and costly conditions. Understanding high inpatient utilization (HIU) among patients with SUD can inform the development of treatment approaches designed to reduce healthcare expenditures and improve service quality. OBJECTIVES: To examine the prevalence, type, and predictors of HIU among patients with SUD and co-occurring mental health conditions. METHODS: Service utilization and demographic and clinical variables were extracted from a national sample of Veterans Health Administration (VA) patients with SUD-only [n = 148,960 (98...
November 2, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29084236/derivation-and-validation-of-a-preoperative-risk-model-for-postoperative-mortality-sampe-model-an-approach-to-care-stratification
#9
Luciana Cadore Stefani, Claudia De Souza Gutierrez, Stela Maris de Jezus Castro, Rafael Leal Zimmer, Felipe Polgati Diehl, Leonardo Elman Meyer, Wolnei Caumo
Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de Clínicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2...
2017: PloS One
https://www.readbyqxmd.com/read/29077292/-scientific-publication-output-of-spanish-emergency-physicians-from-2005-to-2014-a-comparative-study
#10
Inés María Fernández-Guerrero, Francisco Javier Martín-Sánchez, Guillermo Burillo-Putze, Òscar Miró Rafat Sellarés
OBJECTIVES: To analyze the research output of Spanish emergency physicians between 2005 and 2014 and to compare it to their output in the previous 10-year period (1995-2004) as well as to that of emergency physicians in other countries and Spanish physicians in other specialties. MATERIAL AND METHODS: Original articles indexed in the Science Citation Index Expanded of the Web of Science were included. Documents from Spanish emergency physicians were identified by combining the word Spain and any other search term identifying an emergency service or unit in Spain...
October 2017: Emergencias
https://www.readbyqxmd.com/read/29076236/choosing-public-or-private-emergency-departments-in-australia
#11
Katherine Walker, Michael Ben-Meir
Emergency medicine was once exclusively provided in public hospitals in Australia, but now over half a million consultations per annum are in private (7% total emergency consultations). Private EDs have excess capacity and are staffed by senior doctors (majority FACEM) with open access to investigations and broad specialist inpatient services. Public EDs struggle with rising attendances and overcapacity. Private hospitals have high levels of patient satisfaction and aim to optimise service provision. A major barrier to private ED attendances is out-of-pocket costs...
October 26, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29070085/the-south-dakota-model-health-care-professions-student-disaster-preparedness-and-deployment-training
#12
Matt P Owens, Cheri Buffington, Michael P Frost, Randall J Waldner
OBJECTIVE: The Association of American Medical Colleges recommended an increase in medical education for public health emergencies, bioterrorism, and weapons of mass destruction in 2003. The University of South Dakota Sanford School of Medicine (USD SSOM) implemented a 1-day training event to provide disaster preparedness training and deployment organization for health professions students called Disaster Training Day (DTD). METHODS: Hospital staff and emergency medical services personnel provided the lecture portion of DTD using Core Disaster Life Support (CDLS; National Disaster Life Support Foundation) as the framework...
October 26, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29069119/do-combined-pharmacist-and-prescriber-efforts-on-medication-reconciliation-reduce-postdischarge-patient-emergency-department-visits-and-hospital-readmissions
#13
Michelle Baker, Chaim M Bell, Wei Xiong, Edward Etchells, Peter G Rossos, Kaveh G Shojania, Kelly Lane, Tim Tripp, Mary Lam, Kimindra Tiwana, Derek Leong, Gary Wong, Jin-Hyeun Huh Huh, Emily Musing, Olavo Fernandes
BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29062170/diseases-and-molecular-diagnostics-a-step-closer-to-precision-medicine
#14
EDITORIAL
Shailendra Dwivedi, Purvi Purohit, Radhieka Misra, Puneet Pareek, Apul Goel, Sanjay Khattri, Kamlesh Kumar Pant, Sanjeev Misra, Praveen Sharma
The current advent of molecular technologies together with a multidisciplinary interplay of several fields led to the development of genomics, which concentrates on the detection of pathogenic events at the genome level. The structural and functional genomics approaches have now pinpointed the technical challenge in the exploration of disease-related genes and the recognition of their structural alterations or elucidation of gene function. Various promising technologies and diagnostic applications of structural genomics are currently preparing a large database of disease-genes, genetic alterations etc...
October 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#15
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29056910/the-early-awareness-and-alert-system-in-sweden-history-and-current-status
#16
REVIEW
Irene Eriksson, Björn Wettermark, Marie Persson, Morgan Edström, Brian Godman, Anna Lindhé, Rickard E Malmström, Helena Ramström, Mia von Euler, Anna Bergkvist Christensen
Introduction: Over the past decades, early awareness and alert (EAA) activities and systems have gained importance and become a key early health technology assessment (HTA) tool. While a pioneer in HTA, Sweden had no national level EAA activities until 2010. We describe the evolution and current status of the Swedish EAA System. Methods: This was a historical analysis based on the knowledge and experience of the authors supplemented by a targeted review of published and gray literature as well as documents relating to EAA activities in Sweden...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29052534/specialist-advice-may-improve-patient-selection-for-decompression-therapy-following-diving-accidents-a-retrospective-observational-study
#17
Daniel Steffensmeier, Roland Albrecht, Jürg Wendling, Roger Melliger, Donat R Spahn, Philipp Stein, Christophe Wyss
BACKGROUND: Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low. Thus, a collaboration between the Swiss Air-Ambulance (Rega) and the divers alert network (DAN) was initiated to improve patient treatment and identification of decompression injury and necessity of hyperbaric oxygen therapy (HBO)...
October 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29048340/helping-health-services-to-meet-the-needs-of-young-people-with-chronic-conditions-towards-a-developmental-model-for-transition
#18
REVIEW
Albert Farre, Janet E McDonagh
The transition to adult healthcare has been the subject of increased research and policy attention over many years. However, unmet needs of adolescent and young adults (AYAs) and their families continue to be documented, and universal implementation has yet to be realised. Therefore, it is pertinent to re-examine health transition in light of the principles of adolescent medicine from which it emerged, and consider this particular life transition in terms of a developmental milestone rather than a negotiation of structural boundaries between child and adult services...
October 19, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29048133/vasa-previa-prenatal-diagnosis-and-outcomes-thirty-five-cases-from-a-single-maternal-fetal-medicine-practice
#19
Ankita Kulkarni, Jennifer Powel, Michael Aziz, Leena Shah, Susan Lashley, Carlos Benito, Yinka Oyelese
OBJECTIVES: To assess the accuracy and effectiveness of routine screening for vasa previa, to describe our experience, and to assess factors that contribute to missed cases of vasa previa. METHODS: A retrospective descriptive study of all cases of vasa previa from a single maternal-fetal medicine service between 2009 and 2017 was performed. Ultrasound findings and obstetric and neonatal outcomes were reviewed and analyzed. RESULTS: Thirty-five cases of vasa previa were identified...
October 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29042380/potentially-inappropriate-prescribing-and-its-association-with-health-outcomes-in-middle-aged-people-a-prospective-cohort-study-in-ireland
#20
Frank Moriarty, Caitriona Cahir, Kathleen Bennett, Carmel M Hughes, Rose Anne Kenny, Tom Fahey
OBJECTIVES: To determine the prevalence of potentially inappropriate prescribing (PIP) in a cohort of community-dwelling middle-aged people and assess the relationship between PIP and emergency department (ED) visits, general practitioner (GP) visits and quality of life (QoL). DESIGN: Prospective cohort study. SETTING: The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort study of ageing. PARTICIPANTS: Individuals aged 45-64 years recruited to TILDA who were eligible for the means-tested General Medical Services scheme and followed up after 2 years...
October 16, 2017: BMJ Open
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