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Evidence based emergency medicine

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https://www.readbyqxmd.com/read/29784634/evaluation-of-app-based-serious-gaming-as-a-training-method-in-teaching-chest-tube-insertion-to-medical-students-randomized-controlled-trial
#1
Patrick Haubruck, Felix Nickel, Julian Ober, Tilman Walker, Christian Bergdolt, Mirco Friedrich, Beat Peter Müller-Stich, Franziska Forchheim, Christian Fischer, Gerhard Schmidmaier, Michael C Tanner
BACKGROUND: The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce...
May 21, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#2
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29781384/how-to-uncover-sources-of-unwarranted-practice-variation-a-case-study-in-emergency-medicine
#3
Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29761211/comparative-study-of-uma-jeunesse-classic-%C3%A2-and-uma-jeunesse-ultra-%C3%A2
#4
Peeyush P Sharma, Dave Krishan Sharma, Andrew Carr
INTRODUCTION: The emergence of hyaluronic acid dermal fillers with lidocaine has transformed the minimally invasive treatment of wrinkles, lines and folds of the face. Patients can be treated quickly, painlessly and without the need for large doses of lidocaine. Therefore, it is important to scientifically evaluate the merits of lidocaine-containing products over those without. METHODS: The two products, with (UJU) and without lidocaine (UJ), were randomly injected into nasolabial folds of 75 healthy volunteers with varying skin types in a split face study, age ranging 26-60 years...
May 14, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29760865/the-uphill-battle-of-performing-education-scholarship-barriers-educators-and-education-researchers-face
#5
Jaime Jordan, Wendy C Coates, Samuel Clarke, Daniel Runde, Emilie Fowlkes, Jaqueline Kurth, Lalena Yarris
Introduction: Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups' perceptions regarding barriers to scholarship and potential strategies for success. Methods: Core emergency medicine (EM) educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29752833/understanding-diagnostic-safety-in-emergency-medicine-a-case-by-case-review-of-closed-ed-malpractice-claims
#6
Nancy Lemoine, Antonio Dajer, Joseph Konwinski, Dianne Cavanaugh, Catherine Besthoff, Hardeep Singh
The report Improving Diagnosis in Health Care calls for collaboration between professional liability insurance carriers and health care providers to identify opportunities to improve diagnostic performance. We used this collaborative approach and involved risk management/patient safety professionals and emergency medicine physician reviewers to analyze diagnosis-related emergency medicine closed claims from a large malpractice insurer. Our aim was to identify opportunities for risk reduction and to develop an approach for improving at-risk processes...
May 12, 2018: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/29750248/physician-preparedness-for-big-genomic-data-a-review-of-genomic-medicine-education-initiatives-in-the-united-states
#7
Caryn Kseniya Rubanovich, Cynthia Cheung, Jess Mandel, Cinnamon S Bloss
In the last decade, genomic medicine education initiatives have surfaced across the spectrum of physician training in order to help address a gap in genomic medicine preparedness among physicians. The approaches are diverse and stem from the belief that 21st century physicians must be proficient in genomic medicine applications as they will be leaders in the precision medicine movement. We conducted a review of literature in genomic medicine education and training for medical students, graduate medical education, and practicing physicians with articles published between June 2015 and January 2018 to gain a picture of the current state of genomic medicine education with a focus on the United States...
May 10, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29744051/the-academic-surgical-collaborative-a-three-year-review-of-a-trainee-research-collaborative
#8
Thomas E Pidgeon, Charmilie Chandrakumar, Yasser Al Omran, Christopher Limb, Rachel Thavayogan, Buket Gundogan, Kiron Koshy, Amelia White, Alex Fowler, Riaz Agha
Introduction: The Academic Surgical Collaborative (ASC) is a trainee research collaborative (TRC) formed in the UK in October 2014. Three years on, the achievements are presented along with advice for emerging and established TRCs. Methods: A retrospective review of internal, member-maintained ASC records was conducted. Membership numbers, PubMed indexed publications, presentations and prizes awarded were all calculated over time. Google Scholar was used to calculate citations per ASC publication...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29732653/the-regenerative-journey-of-pericytes-towards-clinical-translation
#9
REVIEW
William Cathery, Ashton Faulkner, Davide Maselli, Paolo Madeddu
Coronary artery disease (CAD) is the single leading cause of death worldwide. Advances in treatment and management have significantly improved patient outcomes. On the other hand, although mortality rates have decreased, more people are left with sequelae that require additional treatment and hospitalization. Moreover, patients with severe nonrevascularizable CAD remain with the only option of heart transplantation, which is limited by the shortage of suitable hearts. In recent years, cell-based regenerative therapy has emerged as a possible alternative treatment, with several regenerative medicinal products already in the clinical phase of development and other emerging as competitive preclinical solutions...
May 7, 2018: Stem Cells
https://www.readbyqxmd.com/read/29730774/in-flight-cardiac-arrest-and-in-flight-cardiopulmonary-resuscitation-during-commercial-air-travel-consensus-statement-and-supplementary-treatment-guideline-from-the-german-society-of-aerospace-medicine-dglrm
#10
Jochen Hinkelbein, Lennert Böhm, Stefan Braunecker, Harald V Genzwürker, Steffen Kalina, Fabrizio Cirillo, Matthieu Komorowski, Andreas Hohn, Jörg Siedenburg, Michael Bernhard, Ilse Janicke, Christoph Adler, Stefanie Jansen, Eckard Glaser, Pawel Krawczyk, Mirko Miesen, Janusz Andres, Edoardo De Robertis, Christopher Neuhaus
By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests...
May 5, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29722183/near-infrared-low-level-laser-therapy-and-cell-proliferation-the-emerging-role-of-redox-sensitive-signal-transduction-pathways
#11
REVIEW
Mario Migliario, Maurizio Sabbatini, Carmen Mortellaro, Filippo Renò
Lasers devices are widely used in various medical fields (e.g. surgery, dermatology, dentistry, rehabilitative medicine, etc) for different applications, ranging from surgical ablation of tissues to biostimulation and pain relief. Laser is an electromagnetic radiation which effects on biological tissues strongly depends on a number of physical parameters. Laser wavelength, energy output, irradiation time and modality, temperature and tissue penetration properties have to be set up according to the clinical target tissue and the desired effect...
May 2, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29706132/when-complexity-science-meets-implementation-science-a-theoretical-and-empirical-analysis-of-systems-change
#12
Jeffrey Braithwaite, Kate Churruca, Janet C Long, Louise A Ellis, Jessica Herkes
BACKGROUND: Implementation science has a core aim - to get evidence into practice. Early in the evidence-based medicine movement, this task was construed in linear terms, wherein the knowledge pipeline moved from evidence created in the laboratory through to clinical trials and, finally, via new tests, drugs, equipment, or procedures, into clinical practice. We now know that this straight-line thinking was naïve at best, and little more than an idealization, with multiple fractures appearing in the pipeline...
April 30, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29705478/evidence-based-practice-in-traditional-complementary-medicine-an-agenda-for-policy-practice-education-and-research
#13
Matthew J Leach, Rachel Canaway, Jennifer Hunter
OBJECTIVE: To develop a policy, practice, education and research agenda for evidence-based practice (EBP) in traditional and complementary medicine (T&CM). METHODS: The study was a secondary analysis of qualitative data, using the method of roundtable discussion. The sample comprised seventeen experts in EBP and T&CM. The discussion was audio-recorded, and the transcript analysed using thematic analysis. RESULTS: Four central themes emerged from the data; understanding evidence and EBP, drivers of change, interpersonal interaction, and moving forward...
May 2018: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#14
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29671078/palliative-care-in-heart-failure
#15
REVIEW
Abhinav Sood, Krista Dobbie, W H Wilson Tang
PURPOSE OF REVIEW: This review illustrates the dynamic role of palliative care in heart failure management and encapsulates the commonly utilized pharmacologic and non-pharmacologic therapeutic strategies for symptom palliation in heart failure. In addition, we provide our experience regarding patient care issues common to the domain of heart failure and palliative medicine which are commonly encountered by heart failure teams. RECENT FINDINGS: Addition of palliative care to conventional heart failure management plan results in improvement in quality of life, anxiety, depression, and spiritual well-being among patients...
April 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29663706/patient-specific-bioinks-for-3d-bioprinting-of-tissue-engineering-scaffolds
#16
Negar Faramarzi, Iman K Yazdi, Mahboubeh Nabavinia, Andrea Gemma, Adele Fanelli, Andrea Caizzone, Leon M Ptaszek, Indranil Sinha, Ali Khademhosseini, Jeremy N Ruskin, Ali Tamayol
Bioprinting has emerged as a promising tool in tissue engineering and regenerative medicine. Various 3D printing strategies have been developed to enable bioprinting of various biopolymers and hydrogels. However, the incorporation of biological factors has not been well explored. As the importance of personalized medicine is becoming more clear, the need for the development of bioinks containing autologous/patient-specific biological factors for tissue engineering applications becomes more evident. Platelet-rich plasma (PRP) is used as a patient-specific source of autologous growth factors that can be easily incorporated to hydrogels and printed into 3D constructs...
April 16, 2018: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/29663183/three-visions-of-doctoring-a-gadamerian-dialogue
#17
Benjamin Chin-Yee, Atara Messinger, L Trevor Young
Medicine in the twenty-first century faces an 'identity crisis,' as it grapples with the emergence of various 'ways of knowing,' from evidence-based and translational medicine, to narrative-based and personalized medicine. While each of these approaches has uniquely contributed to the advancement of patient care, this pluralism is not without tension. Evidence-based medicine is not necessary individualized; personalized medicine may be individualized but is not necessarily person-centered. As novel technologies and big data continue to proliferate today, the focus of medical practice is shifting away from the dialogic encounter between doctor and patient, threatening the loss of humanism that many view as integral to medicine's identity...
April 16, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29662881/the-continuum-of-aging-and-age-related-diseases-common-mechanisms-but-different-rates
#18
REVIEW
Claudio Franceschi, Paolo Garagnani, Cristina Morsiani, Maria Conte, Aurelia Santoro, Andrea Grignolio, Daniela Monti, Miriam Capri, Stefano Salvioli
Geroscience, the new interdisciplinary field that aims to understand the relationship between aging and chronic age-related diseases (ARDs) and geriatric syndromes (GSs), is based on epidemiological evidence and experimental data that aging is the major risk factor for such pathologies and assumes that aging and ARDs/GSs share a common set of basic biological mechanisms. A consequence is that the primary target of medicine is to combat aging instead of any single ARD/GSs one by one, as favored by the fragmentation into hundreds of specialties and sub-specialties...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29650071/improving-observational-skills-to-enhance-the-clinical-examination
#19
REVIEW
Stephen W Russell
For much of the 20th century, educators lacked evidence that teaching observational skills could benefit modern medicine. But in 2001, a statistical model emerged that supported the effectiveness of teaching observational skills to medical students using a museum-based curriculum. The story that led to that ground-breaking study, and the consequences that sprung from it, is retold here, traveling from the darkened caves in the foothills of France to the brightly lit galleries of the Yale center for British art...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29644401/-skill-retention-using-extraglottic-airways-in-out-of-hospital-emergencies-efficacy-and-long-term-results-of-simulator-based-medical-education-a-prospective-follow-up-study
#20
V Mann, F Limberg, S T W Mann, S Little, M Müller, M Sander, R Röhrig
OBJECTIVE: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses. METHODS: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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