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Evidence based emergency medicine

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https://www.readbyqxmd.com/read/28212647/an-interpretive-review-of-consensus-statements-on-clinical-guideline-development-and-their-application-in-the-field-of-traditional-and-complementary-medicine
#1
Jennifer Hunter, Matthew Leach, Lesley Braun, Alan Bensoussan
BACKGROUND: Despite ongoing consumer demand and an emerging scientific evidence-base for traditional and complementary medicine (T&CM), there remains a paucity of reliable information in standard clinical guidelines about their use. Often T&CM interventions are not mentioned, or the recommendations arising from these guidelines are unhelpful to end-users (i.e. patients, practitioners and policy makers). Insufficient evidence of efficacy may be a contributing factor; however, often informative recommendations could still be made by drawing on relevant information from other avenues...
February 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28210367/academic-primer-series-eight-key-papers-about-education-theory
#2
Michael Gottlieb, Megan Boysen-Osborn, Teresa M Chan, Sara M Krzyzaniak, Nicolas Pineda, Jordan Spector, Jonathan Sherbino
INTRODUCTION: Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. METHODS: A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210366/blog-and-podcast-watch-cutaneous-emergencies
#3
Andrew Grock, Eric J Morley, Lynn Roppolo, Jay Khadpe, Felix Ankel, Michelle Lin
INTRODUCTION: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of cutaneous emergencies from the AIR series. METHODS: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD) annual testing schedule...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210358/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adults-part-i-introduction-review-and-evidence-based-guidelines
#4
REVIEW
Eric L Anderson, Kimberly Nordstrom, Michael P Wilson, Jennifer M Peltzer-Jones, Leslie Zun, Anthony Ng, Michael H Allen
INTRODUCTION: In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28201852/the-probability-of-probability-and-research-truths
#5
Daniel M Fatovich, Michael Phillips
The foundation of much medical research rests on the statistical significance of the P-value, but we have fallen prey to the seductive certainty of significance. Other scientific disciplines work to a different standard. This may partly explain why medical reversal is an increasing phenomenon, whereby new studies (based on the 0.05 standard) overturn previous significant findings. This has generated a crisis in the rigour of evidence-based medicine, as many people erroneously believe that a P < 0.05 means the treatment effect is clinically important...
February 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28198666/design-connecting-gene-expression-with-therapeutics-for-drug-repurposing-and-development
#6
Bernard Kok Bang Lee, Kai Hung Tiong, Jit Kang Chang, Chee Sun Liew, Zainal Ariff Abdul Rahman, Aik Choon Tan, Tsung Fei Khang, Sok Ching Cheong
BACKGROUND: The drug discovery and development pipeline is a long and arduous process that inevitably hampers rapid drug development. Therefore, strategies to improve the efficiency of drug development are urgently needed to enable effective drugs to enter the clinic. Precision medicine has demonstrated that genetic features of cancer cells can be used for predicting drug response, and emerging evidence suggest that gene-drug connections could be predicted more accurately by exploring the cumulative effects of many genes simultaneously...
January 25, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#7
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28193377/another-time-another-space-the-evolution-of-the-virtual-journal-club
#8
REVIEW
Alison L Chetlen, Carol M Dell, Agnieszka O Solberg, Hansel J Otero, Kirsteen R Burton, Matthew T Heller, Nikita Lakomkin, Stephane L Desouches, Stacy E Smith
Virtual journal clubs (VJCs) provide a standardized, easily accessible forum for evidence-based discussion. The new virtual reality setting in which journal clubs and other online education events now take place offers great advantages and new opportunities for radiologists in academic medicine and private practice. VJCs continue to evolve, largely due to many emerging technologies and platforms. VJCs will continue to play an increasingly important role in medical education, interdisciplinary interaction, and multi-institutional collaboration...
March 2017: Academic Radiology
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#9
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28186708/mesenchymal-stem-cell-derived-extracellular-vesicles-as-mediators-of-anti-inflammatory-effects-endorsement-of-macrophage-polarization
#10
Claudia Lo Sicco, Daniele Reverberi, Carolina Balbi, Valentina Ulivi, Elisa Principi, Luisa Pascucci, Pamela Becherini, Maria Carla Bosco, Luigi Varesio, Chiara Franzin, Michela Pozzobon, Ranieri Cancedda, Roberta Tasso
Mesenchymal Stem Cells (MSCs) are effective therapeutic agents enhancing the repair of injured tissues mostly through their paracrine activity. Increasing evidences show that besides the secretion of soluble molecules, the release of extracellular vesicles (EVs) represents an alternative mechanism adopted by MSCs. Since macrophages are essential contributors toward the resolution of inflammation, which has emerged as a finely orchestrated process, the aim of the present study was to carry out a detailed characterization of EVs released by human adipose derived-MSCs to investigate their involvement as modulators of MSC anti-inflammatory effects inducing macrophage polarization...
January 31, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28179113/traditional-mediterranean-and-european-herbal-medicines
#11
Marco Leonti, Robert Verpoorte
ETHNOPHARMACOLOGICAL RELEVANCE: Written history allows tracing back Mediterranean and European medical traditions to Greek antiquity. The epidemiological shift triggered by the rise of modern medicine and industrialization is reflected in contemporary reliance and preferences for certain herbal medicines. MATERIALS AND METHODS: We sketch the development and transmission of written herbal medicine through Mediterranean and European history and point out the opportunity to connect with modern traditions...
February 4, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28178913/training-us-health-care-professionals-on-human-trafficking-where-do-we-go-from-here
#12
Clydette Powell, Kirsten Dickins, Hanni Stoklosa
: Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#13
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28167494/practising-evidence-based-medicine-ebm-a-descriptive-analysis-of-medical-students-whole-task-ebm-assignments
#14
Lauren A Maggio, Nicole Capdarest-Arest
Researchers have suggested whole-task learning activities to practice and teach evidence-based medicine (EBM); however, limited description exists of their use in EBM curricula. This article describes medical students' execution of a whole-task EBM assignment and characterises themes emerging from assignment submissions. Between 2013 and 2015, Stanford University's paediatric clerkship students completed a whole-task EBM assignment based on a patient encounter. The assignment captured students' efforts to perform all EBM steps and describe their patient scenario and future knowledge needs strategies...
February 6, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28166743/molecular-point-of-care-testing-for-respiratory-viruses-versus-routine-clinical-care-in-adults-with-acute-respiratory-illness-presenting-to-secondary-care-a-pragmatic-randomised-controlled-trial-protocol-respoc
#15
Nathan J Brendish, Ahalya K Malachira, Tristan W Clark
BACKGROUND: Respiratory viruses are associated with a huge socio-economic burden and are responsible for a large proportion of acute respiratory illness in hospitalised adults. Laboratory PCR is accurate but takes at least 24 h to generate a result to clinicians and antigen-based point-of-care tests (POCT) lack sensitivity. Rapid molecular platforms, such as the FilmArray Respiratory Panel, have equivalent diagnostic accuracy to laboratory PCR and can generate a result in 1 h making them deployable as POCT...
February 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28159647/alcohol-stress-and-glucocorticoids-from-risk-to-dependence-and-relapse-in-alcohol-use-disorders
#16
REVIEW
Sara K Blaine, Rajita Sinha
In this review, we detail the clinical evidence supporting the role of psychological and physiological stress in instrumental motivation for alcohol consumption during the development of mild to moderate alcohol use disorders (AUDs) and in the compulsive, habitual alcohol consumption seen in severe, chronic, relapsing AUDs. Traditionally, the study of AUDs has focused on the direct and indirect effects of alcohol on striatal dopaminergic pathways and their role in the reinforcing effects of alcohol. However, growing evidence also suggests that alcohol directly stimulates the hypothalamic pituitary adrenal (HPA) axis and has effects on glucocorticoid receptors in extrahypothalamic, limbic forebrain, and medial Prefrontal Cortex (PFC) circuits, which contribute to the development of AUDs and their progression in severity, chronicity, and relapse risk...
February 1, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28152733/trends-in-cancer-care-with-the-affordable-care-act
#17
Robert Clell Miller
: 46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. METHODS: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148304/human-rights-in-childbirth-narratives-and-restorative-justice-a-review
#18
REVIEW
A U Lokugamage, S D C Pathberiya
This review describes the emerging global debate on the role of human rights childbirth. It is also tailored to a UK perspective in view of the Montgomery v. Lanarkshire [2015] legal ruling and it implications to practice. We can never underestimate the power of humane care on health. The compassion and evidence based medicine agenda in healthcare is interconnected with human rights in healthcare, feeding into the principles of decision making and patient centred care. When this has not happened and there is been healthcare conflict, the power of storytelling serves to connect disparate parties to their common humanity...
February 2, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28144123/state-of-simulation-in-healthcare-education-an-initial-survey-in-beijing
#19
Zichen Zhao, Pengfei Niu, Xiang Ji, Robert M Sweet
BACKGROUND AND OBJECTIVES: In 2013, medical error was the third leading cause of death in the United States.(1) In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. METHODS: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28143942/bridging-the-education-action-gap-a-near-peer-case-based-undergraduate-ethics-teaching-programme
#20
Wing May Kong, Selena Knight
Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies...
January 31, 2017: Journal of Medical Ethics
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