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https://www.readbyqxmd.com/read/28422296/keeping-out-and-getting-in-reframing-emergency-department-gatekeeping-as-structural-competence
#1
Mara Buchbinder
Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28418341/the-knowledge-level-and-opinions-of-physicians-about-the-medical-and-legal-procedures-related-to-physical-child-abuse
#2
Sema Demirçin, Akın Tütüncüler, Fatmagül Aslan, Sevtap Velipaşaoğlu Güney, Mehmet Atılgan, Hakan Gülkesen
BACKGROUND: In order to diagnose child abuse, physicians need to consider the possibility of abuse in every child they encounter, have sufficient information about the topic and manage the cases according to current law. AIMS: To determine the knowledge level of physicians on child abuse and to learn their opinions about the procedures when they suspect child abuse. STUDY DESIGN: A questionnaire (cross-sectional) study. METHODS: A detailed questionnaire was applied to 390 physicians of whom 233 were general practitioners...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28412575/the-role-of-illicit-licit-and-designer-drugs-in-the-traffic-in-hungary
#3
László Institóris, Előd Hidvégi, Adrienn Dobos, Éva Sija, Éva M Kereszty, László Balázs Tajti, Gábor Pál Somogyi, Tibor Varga
The aim of this study was to investigate the prevalence and pattern of psychoactive substances among suspected DUID (Driving Under the Influence of Drugs) drivers in Hungary in 2014 and 2015. Blood and/or urine samples of 1252 suspected drivers (600 in 2014 and 652 in 2015) were analyzed for classical illicit and licit drugs, stimulant designer drugs (SDDs), and for synthetic cannabinoids, with 78.3% and 79.6% positive cases for at least one substance in 2014, and 2015, respectively. Impairment was proven in 39...
April 3, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28399354/epidemiology-of-suicidal-behaviour-in-shumadia-district-serbia-a-fifteen-year-retrospective-study
#4
Snežana Radovanović, Dragan Vasiljević, Mirjana Milosavljević, Ivana Simić-Vukomanović, Svetlana Radević, Nataša Mihailović, Sanja Kocić
OBJECTIVE: The purpose of this study is to analyze epidemiological characteristics of suicide, as well as to emphasize possible risk factors. METHODS: This is a retrospective study, covering the period of fifteen years (1996-2010), which aims at discovering the relevant factors which have an influence on suicidal behaviour. This research uses the data from the documentation of the Ministry of Internal Affairs of Serbia and Police Department in Kragujevac, hospitalization reports of patients treated at Psychiatric Clinic of the Clinical Centre Kragujevac, as well as the medical records of patients treated at the Health Centre Kragujevac...
March 2017: Central European Journal of Public Health
https://www.readbyqxmd.com/read/28379933/communities-social-justice-and-academic-health-centers
#5
Philip M Alberti, Karey M Sutton, Lisa A Cooper, Wendy G Lane, Stacey Stephens, Michelle A Gourdine
In November 2015, the Association of American Medical Colleges (AAMC) held its annual meeting in Baltimore, Maryland. In response both to health and health care inequities faced by residents of Baltimore and to the imminent trial of the police officers charged with Freddie Gray's death, AAMC leaders thought it crucial to address issues of health inequity, social injustice, and the role an academic health center (AHC) can play in improving the health of the community it serves. In collaboration with community-engaged researchers from Johns Hopkins University and University of Maryland, Baltimore, AAMC staff interviewed Baltimore residents, soliciting their perspectives on how medical education, clinical care, and research can and should respond to social injustice and the social determinants of health...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28368905/when-knowledge-and-experience-do-not-help-a-study-of-nonfatal-drug-overdoses
#6
Jake M Najman, Fairlie McIlwraith, Robert Kemp, Andrew Smirnov
: With recent increases in overdose deaths in Australia, there is renewed interest in understanding the factors that contribute to overdose. We examine the experiences of persons who report a nonfatal drug overdose. Fifty people who inject drugs (PWID) and who had accidently overdosed in the past 12 months were recruited and interviewed at 1 of 4 Needle and Syringe Program sites during September and October 2013.Participants were typically male, middle-aged, with long injecting histories. Half of the participants reported mainly injecting pharmaceutical opioids...
March 31, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28351023/effect-of-door-locking-policy-on-inpatient-treatment-of-substance-use-and-dual-disorders
#7
Regine Steinauer, Christian G Huber, Sylvie Petitjean, Gerhard A Wiesbeck, Kenneth M Dürsteler, Undine E Lang, Christian Seifert, Katja Andreeff, Michael Krausz, Marc Walter, Marc Vogel
OBJECTIVE: Substance use treatment is often performed inside locked wards. We investigate the effects of adopting a policy of open-door treatment for a substance use treatment and dual diagnosis ward. METHODS: This is a prospective open-label study investigating 3-month study periods before opening (P1), immediately after (P2), and 1 year after the first period (P3). Data on committed patients, coercion (seclusion, forced medication, absconding events with subsequent police search), violence, and substance use was collected daily...
March 29, 2017: European Addiction Research
https://www.readbyqxmd.com/read/28348911/a-case-of-persistent-generalized-retrograde-autobiographical-amnesia-subsequent-to-the-great-east-japan-earthquake-in-2011
#8
Yuji Odagaki
Functional retrograde autobiographical amnesia is often associated with physical and/or psychological trauma. On 11 March 2011, the largest earthquake on record in Japan took place, and subsequent huge tsunami devastated the Pacific coast of northern Japan. This case report describes a patient suffering from retrograde episodic-autobiographical amnesia for whole life, persisting for even more than five years after the disaster. A Japanese man, presumably in his 40s, got police protection in April 2016 but was unable to respond to question about his own name...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28343794/sickness-presenteeism-among-health-care-providers-in-an-academic-tertiary-care-center-in-riyadh
#9
Mohammed Al Nuhait, Khaled Al Harbi, Amjad Al Jarboa, Rami Bustami, Shmaylan Alharbi, Abdulkareem Albekairy, Hind Almodaimegh
The term sickness presenteeism (SP) has been described as the act of going to work despite having a state of health that may be regarded as poor enough to justify sick leave. SP has been observed to be prevalent among three-quarters of health care providers (HCPs). Working while sick not only puts patients at risk but also decreases productivity and increases the probability of medical errors. Moreover, SP has been identified as a risk factor for many negative health outcomes among the HCPs themselves, such as depression, burnout, and serious cardiac events...
March 23, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28339340/patient-perspectives-on-language-discordance-during-healthcare-visits-findings-from-the-extremely-high-density-multicultural-state-of-qatar
#10
Huda Abdelrahim, Maha Elnashar, Amal Khidir, Amal Killawi, Maya Hammoud, Abdul Latif Al-Khal, Michael D Fetters
Reducing language and cultural barriers in healthcare are significant factors in resolving health disparities. Qatar's rapidly growing multicultural population presents new challenges to the healthcare system. The purpose of this research was to explore patients' perspectives about language discordance, and the strategies used to overcome language barriers during patients' visits. Participants were recruited and interviewed from four language groups (Arabic = 24, English = 20, Hindi = 20, and Urdu = 20), all of whom were living in Qatar and utilizing Hamad General Hospital-Outpatient Clinics as a source of their healthcare services...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28323542/organized-abuse-in-adulthood-survivor-and-professional-perspectives
#11
Michael Salter
This paper reports on the preliminary findings of a qualitative study of Australian women disclosing organized abuse in adulthood and the mental health professionals who treat them. Drawing on interviews with survivors and mental health professionals, the paper analyses the fraught relationship between mental health and physical safety for adults subject to organized abuse. The therapeutic progress of adult organized abuse victims can be disrupted by ongoing threats, stalking, and group violence, which in turn reinforces the dissociative responses and pathological attachments that render them vulnerable to revictimization...
February 23, 2017: Journal of Trauma & Dissociation
https://www.readbyqxmd.com/read/28323470/police-brutality-and-black-health-setting-the-agenda-for-public-health-scholars
#12
Sirry Alang, Donna McAlpine, Ellen McCreedy, Rachel Hardeman
We investigated links between police brutality and poor health outcomes among Blacks and identified five intersecting pathways: (1) fatal injuries that increase population-specific mortality rates; (2) adverse physiological responses that increase morbidity; (3) racist public reactions that cause stress; (4) arrests, incarcerations, and legal, medical, and funeral bills that cause financial strain; and (5) integrated oppressive structures that cause systematic disempowerment. Public health scholars should champion efforts to implement surveillance of police brutality and press funders to support research to understand the experiences of people faced with police brutality...
May 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28321035/disaster-victim-identification-using-orthopedic-implants-in-the-2011-east-japan-earthquake-and-tsunami
#13
Norio Numata, Haruka Makinae, Wataru Yoshida, Masao Daimon, Hideki Murakami
On March 11, 2011, an earthquake (magnitude 9.0) devastated Japan's east coast, and the associated tsunami resulted in social and mechanical destruction. Search for the missing people is still ongoing. Surgical implants are common in the general population. Medical implants usually have lot numbers, and their forensic use is common for victim identification. This investigation was conducted mainly in the cities of Kamaishi and Otsuchi, both of which were affected by the tsunami disaster in 2011. We visited 6 mortuaries with the police between March 20 (9 days after the tsunami) and April 20 (40 days after the tsunami) to examine the presence of surgical scars and related information...
March 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28318461/the-event-chain-of-survival-in-the-context-of-music-festivals-a-framework-for-improving-outcomes-at-major-planned-events
#14
Adam Lund, Sheila Turris
Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs)...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28317200/self-limiting-non-medical-pharmaceutical-opioid-use-among-young-people-in-sydney-australia-an-exploratory-study
#15
George C Dertadian, Thomas C Dixon, Jennifer Iversen, Lisa Maher
INTRODUCTION AND AIMS: Indicators suggest an escalation in opioid use globally, with recent HIV outbreaks linked to non-medical pharmaceutical opioid (NMPO) use. Little is known about how young Australians engage in NMPO use. DESIGN AND METHODS: During 2015, we conducted qualitative interviews with young people (16-29 years) who reported oral NMPO use at least twice in the past 90 days. The study included a sample of injecting (n = 14) and oral (n = 22) users...
March 20, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28302306/further-victimization-of-child-sexual-abuse-victims-a-latent-class-typology-of-re-victimization-trajectories
#16
Nina L Papalia, Stefan Luebbers, James R P Ogloff, Margaret Cutajar, Paul E Mullen, Emily Mann
The association between child sexual abuse (CSA) and risk for re-victimization is well-documented; however, less is known about the temporal progression of re-victimization experiences over the early life-course among CSA survivors, and whether this differs from that of those without known sexual abuse histories. This study investigated whether there are distinct temporal pathways of interpersonal re-victimization between the ages of 10-25 years among medically confirmed CSA cases, and considered whether abuse variables, re-victimization variables, and the presence of other adverse outcomes, were associated with heterogeneity in re-victimization pathways...
March 13, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28299558/body-pushing-prescription-drugs-and-hospital-admission
#17
Roger W Byard, Michaela Kenneally
A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police...
March 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28289792/-stalking-of-psychiatrists-and-psychotherapists-results-of-an-online-survey
#18
P Praus, S Riedel-Heller, H Dressing
BACKGROUND: Currently, there are clear indications that due to their exposed occupational position psychiatrists and psychotherapists are at a higher risk than the general public to become the victim of stalking by patients. OBJECTIVES: This study investigated the frequency of stalking and its psychosocial impact among psychiatrists and psychotherapists in the Federal Republic of Germany. METHODS: Analysis of an online survey among members of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) from 23 September 2015 until 22 October 2015...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28280059/a-medical-curriculum-in-transition-audit-and-student-perspective-of-undergraduate-teaching-of-ethics-and-professionalism
#19
Toni C Saad, Stephen Riley, Richard Hain
INTRODUCTION: The General Medical Council (GMC) stipulates that doctors must be competent professionals, not merely scholars and practitioners. Medical school curricula should enable students to develop professional values and competencies. Additionally, medical schools are moving towards integrated undergraduate curricula, Cardiff's C21 being one such example. METHODS: We carried out an audit to determine the extent to which C21 delivers GMC professionalism competencies, and a student questionnaire to explore student perspective on ethics and professionalism...
March 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28261791/drug-recognition-evaluation-and-chemical-confirmation-of-a-25c-nbome-impaired-driver
#20
James W Rajotte, Jean-Paul F P Palmentier, Helena Rachelle Wallage
This case report details an individual arrested for drug-impaired driving after leaving the scene of multiple motor vehicle collisions and evading police. The driver was examined by a drug recognition expert and failed the drug recognition evaluation. The driver admitted to using cocaine, marijuana, an antidepressant medication and "N-bomb," a novel psychoactive substance that possesses hallucinogenic properties. Toxicological analyses at the Centre of Forensic Sciences' Toronto laboratory revealed only the substance 2-[4-chloro-2,5-dimethoxyphenyl]-N-[(2-methoxyphenyl)methyl]ethanamine (25C-NBOMe) in the accused's urine...
March 6, 2017: Journal of Forensic Sciences
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