Science.gov

Sample records for emergency medicine public

  1. A systematic review of retracted publications in emergency medicine.

    PubMed

    Chauvin, Anthony; De Villelongue, Cedric; Pateron, Dominique; Yordanov, Youri

    2017-08-18

    The objective of this study was to characterize retracted publications in emergency medicine. We searched MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials to identify all retracted publications in the field of emergency medicine. We also searched an independent website that reports and archives retracted scientific publications. Two researchers independently screened titles, abstracts and full text of search results. Data from all included studies were then independently extracted. We identified 28 retraction notes. Eleven (39%) articles were published by authors from Europe. The oldest retracted article was published in 2001. The 28 retracted papers were published by 22 different journals. Two authors were named on multiples retractions. The median impact factor of journals was 1.03 (0.6-1.9). Almost all studies were available online [26/28 (93%)], but only 40% had watermarking on the article. The retraction notification was available for all articles. Three (11%) retraction notices did not clearly report the retraction reasons, and most retraction notices were issued by the editors [14 (56%)]. The most frequent retraction reasons were plagiarism [eight (29%)], duplicate publication [three (11%)] and overlap [two (2%)]. Retracted articles were cited on average 14 times. In most cases, the retraction cause did not invalidate the study's results [17 (60%)]. The most common reason for retraction was related to a misconduct by the authors. These results can question the necessity to normalize retraction procedures among the large number of biomedical editors and to educate future researchers on research integrity.

  2. Full text publication rates of studies presented at an international emergency medicine scientific meeting.

    PubMed

    Chan, Jannet W M; Graham, Colin A

    2011-09-01

    The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

  3. Survey of publications and the H-index of Academic Emergency Medicine Professors.

    PubMed

    Babineau, Matthew; Fischer, Christopher; Volz, Kathryn; Sanchez, Leon D

    2014-05-01

    The number of publications and how often these have been cited play a role in academic promotion. Bibliometrics that attempt to quantify the relative impact of scholarly work have been proposed. The h-index is defined as the number (h) of publications for an individual that have been cited at least h times. We calculated the h-index and number of publications for academic emergency physicians at the rank of professor. We accessed the Society for Academic Emergency Medicine professor list in January of 2012. We calculated the number of publications through Web of Science and PubMed and the h-index using Google scholar and Web of Science. We identified 299 professors of emergency medicine. The number of professors per institution ranged from 1 to 13. Median h-index in Web of Science was 11 (interquartile range [IQR] 6-17, range 0-51), in Google Scholar median h-index was 14 (IQR 9-22, range 0-63) The median number of publications reported in Web of Science was 36 (IQR 18-73, range 0-359. Total number of publications had a high correlation with the h-index (r=0.884). The h-index is only a partial measure of academic productivity. As a measure of the impact of an individual's publications it can provide a simple way to compare and measure academic progress and provide a metric that can be used when evaluating a person for academic promotion. Calculation of the h-index can provide a way to track academic progress and impact. [West J Emerg Med. 2014;15(3):290-292.].

  4. The globalization of emergency medicine and its importance for public health.

    PubMed Central

    Anderson, Philip; Petrino, Roberta; Halpern, Pinchas; Tintinalli, Judith

    2006-01-01

    Emergency medicine (EM) is a global discipline that provides secondary disease prevention and is also a tool for primary prevention. It is a horizontally integrated system of emergency care consisting of access to EM care; provision of EM care in the community and during transportation of patients; and provision of care at the receiving facility or hospital emergency department. EM can offer many tools to improve public health. These tools include primary disease prevention; interventions for addressing substance abuse and interpersonal violence; education about safety practices; epidemiological surveillance; enrolment of patients in clinical research trials focusing on acute interventions; education and clinical training of health-care providers; and participation in local and regional responses to natural and man-made disasters. Public health advocates and health policy-makers can benefit from the opportunities of EM and can help overcome its challenges. Advocating the establishment and recognition of the specialty of EM worldwide can result in benefits for health-care education, help in incorporating the full scope of EM care into the system of public health, and expand the capabilities of EM for primary and secondary prevention for the benefit of the health of the public. PMID:17128364

  5. Publication rate of abstracts presented at the emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012.

    PubMed

    Kalkan, Asim; Kose, Ozkan; Bilir, Ozlem; Ersunan, Gokhan; Ozel, Deniz; Guler, Ferhat

    2015-09-01

    The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the

  6. Critical appraisal of emergency medicine educational research: the best publications of 2009.

    PubMed

    Kuhn, Gloria J; Shayne, Philip; Coates, Wendy C; Fisher, Jonathan; Lin, Michelle; Maggio, Lauren A; Farrell, Susan E

    2010-10-01

    The objective was to critically appraise and highlight methodologically superior medical education research specific to emergency medicine (EM) published in 2009. A search of the English language literature in 2009 querying Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE 1950 to Present, Web of Science, Education Resources Information Center (ERIC), and PsychInfo identified 36 EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This was a refinement of the methods used to appraise medical education published in 2008. Seven studies met the standards as determined by the averaged rankings and are highlighted and summarized here. This year, 16 of 36 (44%) identified studies had funding, compared to 11 of 30 (36%) identified last year; five of seven (71%) highlighted publications were funded in 2009 compared to three of five (60%) highlighted in 2008. Use of technology in medical education was reported in 14 identified and four highlighted publications, with simulation being the most common technology studied. Five of the seven (71%) featured publications used a quasi-experimental or experimental design, one was observational, and one was qualitative. Practice management topics, including patient safety, efficiency, and revenue generation, were examined in seven reviewed studies. Thirty-six medical education publications published in 2009 focusing on EM were identified. This critical appraisal reviews and highlights seven studies that met a priori quality indicators. Current trends are noted. © 2010 by the Society for Academic Emergency Medicine.

  7. Critical appraisal of emergency medicine education research: the best publications of 2013.

    PubMed

    Farrell, Susan E; Kuhn, Gloria J; Coates, Wendy C; Shayne, Phillip H; Fisher, Jonathan; Maggio, Lauren A; Lin, Michelle

    2014-11-01

    The objective was to critically appraise and highlight methodologically superior medical education research articles published in 2013 whose outcomes are pertinent to teaching and education in emergency medicine (EM). A search of the English-language literature in 2013 querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 251 EM-related studies using hypothesis-testing or observational investigations of educational interventions. Two reviewers independently screened all of the publications and removed articles using established exclusion criteria. Six reviewers then independently scored the remaining 43 publications using either a qualitative a or quantitative scoring system, based on the research methodology of each article. Each scoring system consisted of nine criteria. Selected criteria were based on accepted educational review literature and chosen a priori. Both scoring systems used parallel scoring metrics and have been used previously within this annual review. Forty-three medical education research papers (37 quantitative and six qualitative studies) met the a priori criteria for inclusion and were reviewed. Six quantitative and one qualitative study were scored and ranked most highly by the reviewers as exemplary and are summarized in this article. This annual critical appraisal article aims to promote superior research in EM-related education, by reviewing and highlighting seven of 43 major education research studies, meeting a priori criteria, and published in 2013. Common methodologic pitfalls in the 2013 papers are noted, and current trends in medical education research in EM are discussed. © 2014 by the Society for Academic Emergency Medicine.

  8. Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2014.

    PubMed

    Yarris, Lalena M; Juve, Amy Miller; Coates, Wendy C; Fisher, Jonathan; Heitz, Corey; Shayne, Philip; Farrell, Susan E

    2015-11-01

    The objective was to critically appraise and highlight rigorous education research study articles published in 2014 whose outcomes advance the science of emergency medicine (EM) education. A search of the English language literature in 2014 querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 243 EM-related articles using either quantitative (hypothesis-testing or observational investigations of educational interventions) or qualitative (exploring important phenomena in EM education) methods. Two reviewers independently screened all of the publications using previously established exclusion criteria. Six reviewers then independently scored the 25 selected publications using either a qualitative or a quantitative scoring system. Each scoring system consisted of nine criteria. Selected criteria were based on accepted educational review literature and chosen a priori. Both scoring systems use parallel scoring metrics and have been used previously within this annual review. Twenty-five medical education research papers (22 quantitative, three qualitative) met the criteria for inclusion and were reviewed. Five quantitative and two qualitative studies were ranked most highly by the reviewers as exemplary and are summarized in this article. This annual critical appraisal series highlights seven excellent EM education research studies, meeting a priori criteria and published in 2014. Methodologic strengths in the 2014 papers are noted, and current trends in medical education research in EM are discussed. © 2015 by the Society for Academic Emergency Medicine.

  9. Emergency medicine public health research funded by federal agencies: progress and priorities.

    PubMed

    D'Onofrio, Gail; Goldstein, Amy B; Denisco, Richard A; Hingson, Ralph; Heffelfinger, James D; Post, Lori A

    2009-11-01

    The emergency department (ED) visit provides an opportunity to impact the health of the public throughout the entire spectrum of care, from prevention to treatment. As the federal government has a vested interest in funding research and providing programmatic opportunities that promote the health of the public, emergency medicine (EM) is prime to develop a research agenda to advance the field. EM researchers need to be aware of federal funding opportunities, which entails an understanding of the organizational structure of the federal agencies that fund medical research, and the rules and regulations governing applications for grants. Additionally, there are numerous funding streams outside of the National Institutes of Health (NIH; the primary federal health research agency). EM researchers should seek funding from agencies according to each agency's mission and aims. Finally, while funds from the Department of Health and Human Services (HHS) are an important source of support for EM research, we need to look beyond traditional sources and appeal to other agencies with a vested interest in promoting public health in EDs. EM requires a broad skill set from a multitude of medical disciplines, and conducting research in the field will require looking for funding opportunities in a variety of traditional and not so traditional places within and without the federal government. The following is the discussion of a moderated session at the 2009 Academic Emergency Medicine consensus conference that included panel discussants from the National Institutes of Mental Health, Drug Abuse, and Alcoholism and Alcohol Abuse and the Centers for Disease Control and Prevention (CDC). Further information is also provided to discuss those agencies and centers not represented.

  10. Critical appraisal of emergency medicine education research: the best publications of 2012.

    PubMed

    Lin, Michelle; Fisher, Jonathan; Coates, Wendy C; Farrell, Susan E; Shayne, Philip; Maggio, Lauren; Kuhn, Gloria

    2014-03-01

    The objective was to critically appraise and highlight medical education research published in 2012 that was methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). A search of the English language literature in 2012 querying Education Resources Information Center (ERIC), PsychInfo, PubMed, and Scopus identified EM studies using hypothesis-testing or observational investigations of educational interventions. Two reviewers independently screened all of the publications and removed articles using established exclusion criteria. This year, publications limited to a single-site survey design that measured satisfaction or self-assessment on unvalidated instruments were not formally reviewed. Six reviewers then independently ranked all remaining publications using one of two scoring systems depending on whether the study methodology was primarily qualitative or quantitative. Each scoring system had nine criteria, including four related to methodology, that were chosen a priori, to standardize evaluation by reviewers. The quantitative study scoring system was used previously to appraise medical education published annually in 2008 through 2011, while a separate, new qualitative study scoring system was derived and implemented consisting of parallel metrics. Forty-eight medical education research papers met the a priori criteria for inclusion, and 33 (30 quantitative and three qualitative studies) were reviewed. Seven quantitative and two qualitative studies met the criteria for inclusion as exemplary and are summarized in this article. This critical appraisal series aims to promote superior education research by reviewing and highlighting nine of the 48 major education research studies with relevance to EM published in 2012. Current trends and common methodologic pitfalls in the 2012 papers are noted. © 2014 by the Society for Academic Emergency Medicine.

  11. Critical appraisal of emergency medicine educational research: the best publications of 2011.

    PubMed

    Fisher, Jonathan; Lin, Michelle; Coates, Wendy C; Kuhn, Gloria J; Farrell, Susan E; Maggio, Lauren A; Shayne, Philip

    2013-02-01

    The objective was to critically appraise and highlight medical education research studies published in 2011 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). A search of the English language literature in 2011 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008, 2009, and 2010. Forty-eight educational research papers were identified. Comparing the literature of 2011 to that of 2008 through 2010, the number of published educational research papers meeting the criteria increased over time from 30, to 36, to 41, and now to 48. Five medical education research studies met the a priori criteria for inclusion as exemplary and are reviewed and summarized in this article. The number of funded studies remained fairly stable over the past 3 years, at 13 (2008), 16 (2009), 9 (2010), and 13 (2011). As in past years, research involving the use of technology accounted for almost half (n = 22) of the publications. Observational study designs accounted for 28 of the papers, while nine studies featured an experimental design. Forty-eight EM educational studies published in 2011 and meeting the criteria were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2011 papers are noted. © 2013 by the Society for Academic Emergency Medicine.

  12. The progress of emergency medicine in Taiwan, China, and Hong Kong: perspective from publications in Emergency Medicine Journals, 1992-2011.

    PubMed

    Lee, Ching-Hsing; Chaou, Chung-Hsien; Lin, Chih-Chuan

    2014-01-01

    The progress of emergency medicine (EM) in Taiwan, China, and Hong Kong was evaluated from the perspective of publications in EM journals. This was a retrospective study. All articles published from 1992 to 2011 in all journals in the EM category in the 2010 Journal Citation Reports (JCR) were included. A computerized literature search was conducted using the SciVerse Scopus database. The slope ( β ) of the linear regression was used to evaluate the trends in the numbers of articles as well as the ratios to the total number of EM journal articles. The trends in the numbers of articles from Taiwan, China, and Hong Kong were 6.170, 1.908, and 2.835 and the trends in the ratios of their publication numbers to the total number of EM journal articles were 15.0 × 10(-4), 4.60 × 10(-4), and 6.80 × 10(-4), respectively. All P-values were <0.01. The mean, median, and 75th percentiles of the number of citations in all EM journals were greater than those of these three areas. The publications from Taiwan, China, and Hong Kong have increased at a higher rate than those of the overall EM field in the past 20 years and indicated the rapid progress in these three areas.

  13. Humanism in emergency medicine.

    PubMed

    Rosenzweig, S

    1993-09-01

    Emergency medicine has not yet appropriated "humanism" as a term of its own. Medical humanism needs to be interpreted in a way that is consistent with the practical goals of emergency medicine. In this essay, humanism in emergency medicine is defined by identifying the dehumanizing aspects of sudden illness and exploring of ways for sustaining the humanity of emergency department patients. Excerpts from Dr Oliver Sacks' autobiographical work A Leg to Stand On give voice to the human needs created by sudden illness and its treatment.

  14. The emerging landscape of reimbursement of regenerative medicine products in the UK: publications, policies and politics.

    PubMed

    Mahalatchimy, Aurélie; Faulkner, Alex

    2017-10-03

    This paper aims to map the trends and analyze key institutional dynamics that constitute the policies for reimbursement of regenerative medicine (RM), especially in the UK. Two quantitative publications studies using Google Scholar and a qualitative study based on a larger study of 43 semi-structured interviews. Reimbursement has been a growing topic of publications specific to RM and independent from orphan drugs. Risk-sharing schemes receive attention among others for dealing with RM reimbursement. Trade organizations have been especially involved on RM reimbursement issues and have proposed solutions. The policy and institutional landscape of reimbursement studies in RM is a highly variegated and conflictual one and in its infancy.

  15. Medicine and the Public:

    PubMed Central

    Berridge, Virginia

    2007-01-01

    The 1962 report of the Royal College of Physicians on smoking was a significant event in the history of smoking. Its significance was, however, more than smoking-specific: the RCP committee's appointment, its membership, its work, and the manner of its publication signified the changes within social medicine, and within the medical profession more generally, in postwar Britain. Doctors assumed the right to speak to the public and to government on matters of individual health, and a new risk-based public health was in the process of formation. A public health “policy community” formed, and governments began to assume responsibility for advising the public on health matters. The use of research in the report, and of social research in response to it, was important in the emergence of evidence-based medicine within public health. The paper argues for greater attention to the change in public health epitomized by the report in current debates on the concept of the 1960s “permissive society.” It was the harbinger of a new style of “coercive permissiveness” in health. PMID:17369672

  16. Emergency medicine in space.

    PubMed

    Stewart, Lowan H; Trunkey, Donald; Rebagliati, G Steve

    2007-01-01

    Recent events, including the development of space tourism and commercial spaceflight, have increased the need for specialists in space medicine. With increased duration of missions and distance from Earth, medical and surgical events will become inevitable. Ground-based medical support will no longer be adequate when return to Earth is not an option. Pending the inclusion of sub-specialists, clinical skills and medical expertise will be required that go beyond those of current physician-astronauts, yet are well within the scope of Emergency Medicine. Emergency physicians have the necessary broad knowledge base as well as proficiency in basic surgical skills and management of the critically ill and injured. Space medicine shares many attributes with extreme conditions and environments that many emergency physicians already specialize in. This article is an introduction to space medicine, and a review of current issues in the emergent management of medical and surgical disease during spaceflight.

  17. [Ultrasound in emergency medicine].

    PubMed

    Lapostolle, F; Deltour, S; Petrovic, T

    2015-12-01

    Ultrasound has revolutionized the practice of emergency medicine, particularly in prehospital setting. About a patient with dyspnea, we present the role of ultrasound in the diagnosis and emergency treatment. Echocardiography, but also hemodynamic ultrasound (vena cava) and lung exam are valuable tools. Achieving lung ultrasound and diagnostic value of B lines B are detailed.

  18. Academic emergency medicine in India.

    PubMed

    Pothiawala, Sohil; Anantharaman, Venkataraman

    2013-08-01

    Emergency medicine (EM) was recognized as a specialty by the Medical Council of India (MCI) in July 2009. As India undergoes urbanisation, cost-effective transition from managing infectious diseases to emergency management of trauma and cardio-respiratory diseases is crucial. Trained emergency healthcare workers are needed to respond effectively to these challenges. The objective was to determine the current status of academic EM training and related issues in India, and to discuss those that need to be addressed. The authors conducted electronic literature searches for articles published over an 18 year period from January 1994 to February 2013 using PubMed, Google and Yahoo databases. The references listed in the publications identified from these databases were also reviewed. Electronic literature searches revealed a multitude of 1 to 3 year training programmes, many affiliated with various foreign universities. The majority of these training programmes are offered in private healthcare institutions. MCI recognition has opened the doors for medical colleges to set up Indian specialty training programmes. Two separate Academic Councils are currently looking at EM training. The variety of programmes and separate efforts on academic development begets a need to address the issues of short-term courses being passed off as specialty training programmes, and a need for working together on national curriculum development, certification, accreditation systems and common examinations. The different organisations and academic councils could collaborate to give EM a unified scope for development. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Emergency medicine ultrasonography

    PubMed Central

    Woo, Michael Y.; Nussbaum, Chris; Lee, A. Curtis

    2009-01-01

    ABSTRACT OBJECTIVE To survey program directors of family medicine–emergency medicine (CCFP[EM]) training programs regarding current and future emergency medicine ultrasonography (EMUS) training. DESIGN A Web-based survey using a modified Dillman method. Two academic emergency physicians reviewed the validity and reliability of the survey. SETTING Canada. PARTICIPANTS Program directors of all 17 Canadian CCFP(EM) residency training programs in 2006. MAIN OUTCOME MEASURES Characteristics of EMUS training currently offered and program directors’ perceptions of needs for future EMUS training. RESULTS The survey, performed in 2006, had a response rate of 100% (17/17), although not all respondents answered all questions. At the time of the study, 82.4% of respondents’ programs used EMUS. Although all program directors recommended that residents attend introductory EMUS courses, only 71.4% (10/14) of programs offered such courses; 60.0% (9/15) of those were mandatory. In one-third of the programs, more than 75% of the attending staff used EMUS. A total of 76.5% of program directors thought that introductory courses in EMUS should be mandatory; 62.5% (10/16) believed that residents were able to acquire sufficient experience to use EMUS independently to make practice decisions before completion of their residency; and 88.2% believed that EMUS should be a part of the scope of practice for emergency medicine physicians. Only 58.8% believed that there should be questions about EMUS on the CCFP(EM) Certification examination. Open responses indicated that funding, resources, and standardization were issues that needed to be addressed. CONCLUSION Formal EMUS training for CCFP(EM) programs is being introduced in Canada. Quality assurance needs to be strengthened. Most program directors thought that an introductory course in EMUS should be mandatory. Fewer directors, however, believed EMUS should be on the CCFP(EM) Certification examination until further funding, resources

  20. [Teaching in emergency medicine].

    PubMed

    Ayuso, Fernando; Nogué, R; Coll Vinent, Begoña; Fernández Esáin, Begoña; Miró, O

    2010-01-01

    The appropriate care of patients in emergency services can reach a level of complexity as to make a sound training necessary, which should be based on a medical specialty, as happens in the majority of the countries in our context. In Spain at present there is no regulated and homogeneous training in urgency and emergency medicine (UEM), either during the period of undergraduate training (in the form of a universally compulsory subject in the faculties of medicine) or during the postgraduate period (in the form of a medical specialty). In this respect, the definitive approval of the specialty in UEM is currently pending within the framework of a reform of the residence program that will evolve towards a core training program of specialties. Until thus occurs, the reality in Spain is that professionals who work in this care setting possess a heterogeneous training. As a result of this vacuum and the training needs of these professionals, a wide range of specific training proposals has been developed over the years in order to optimise the skills and abilities of the professionals who provide initial emergency care to the patient. A new generation of courses has been set underway using the new didactic methodologies of training, into which didactic tools of e-learning and robotic simulation have been incorporated.

  1. The Frontlines of Medicine Project: a proposal for the standardized communication of emergency department data for public health uses including syndromic surveillance for biological and chemical terrorism.

    PubMed

    Barthell, Edward N; Cordell, William H; Moorhead, John C; Handler, Jonathan; Feied, Craig; Smith, Mark S; Cochrane, Dennis G; Felton, Christopher W; Collins, Michael A

    2002-04-01

    The Frontlines of Medicine Project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. This collaboration proposes to develop a nonproprietary, "open systems" approach for reporting emergency department patient data. The common element is a standard approach to sending messages from individual EDs to regional oversight entities that could then analyze the data received. ED encounter data could be used for various public health initiatives, including syndromic surveillance for chemical and biological terrorism. The interlinking of these regional systems could also permit public health surveillance at a national level based on ED patient encounter data. Advancements in the Internet and Web-based technologies could allow the deployment of these standardized tools in a rapid time frame.

  2. [Ambulance in emergency medicine].

    PubMed

    Aksoy, Fikret; Ergun, Alper

    2002-07-01

    The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

  3. The future of emergency medicine.

    PubMed

    Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michele; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Kruger, Jennifer; Stratford, Cary J; Jouriles, Nicholas

    2010-07-01

    Physician shortages are being projected for most medical specialties. The specialty of emergency medicine continues to experience a significant workforce shortage in the face of increasing demand for emergency care. The limited supply of emergency physicians, emergency nurses, and other resources is creating an urgent, untenable patient care problem. In July 2009, representatives of the leading emergency medicine organizations met in Dallas, TX, for the Future of Emergency Medicine Summit. This consensus document, agreed to and cowritten by all participating organizations, describes the substantive issues discussed and provides a foundation for the future of the specialty.

  4. Homeopathy in emergency medicine.

    PubMed

    Oberbaum, Menachem; Singer, Shepherd Roee; Friehs, Helmut; Frass, Michael

    2005-11-01

    Use of homeopathy is not frequently reported in critically ill patients. We describe our experience treating such patients homeopathically in the emergency room, on the wards, and in the intensive care unit of conventional hospitals in Austria and Israel. We describe a case series of patients treated in the ER for multiple casualty incidents, two case reports of remarkable cures in the ICU, and two RCTs demonstrating the efficacy of homeopathy in septic and intubated patients. A case series documents favorable results in homeopathic treatment of patients in the ER and wards after multiple casualty incidents. Two case reports narration e remarkable homeopathic cures to imminently terminal illnesses. Finally, homeopathy was demonstrated effective as compared with placebo in improving long-term survival in severely ill septic patients and in hastening extubation ICU patients. Our report suggests that homeopathy may be applicable even for critically ill patients. We discuss the obstacles encountered, including a dearth of tools for successful homeopathic prescription in these situations, suspicion and lack of cooperation by patients and conventional colleagues, and the highly suppressive nature of concomitant conventional therapies. We suggest the development of algorithms and other tools to aid rapid homeopathic prescription in critical care patients and discuss the importance of familiarizing physicians and medical students with homeopathy in order to facilitate communication and cooperation between these complementary branches of medicine.

  5. Emergency medicine in Dubai, UAE.

    PubMed

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-08-18

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  6. Zoological medicine and public health.

    PubMed

    Chomel, Bruno B; Osburn, Bennie I

    2006-01-01

    Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of public health into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or public health with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in public health and wildlife management.

  7. Radiology in emergency medicine

    SciTech Connect

    Levy, R.; Barsan, W.G.

    1986-01-01

    This book gives a discussion of radiologic modalities currently being used in emergency situations. Radiographs, echocardiographs, radionuclide scans and CT scans are systematically analyzed and evaluated to provide a step-by-step diagnostic process for emergency physicians to follow when a radiologist is not present.

  8. Tennessee emergency medicine workforce, 2009.

    PubMed

    Keenum, Amy J; Rawlings, Luke M; Odoi, Agricola; Wortley, Michael G; Lamsen, Leonard; Jones, Louis; Wallace, Lorraine S

    2013-03-01

    Describe the characteristics of the Tennessee (TN) Emergency Medicine (EM) workforce. A cross-sectional mail survey of all non-government emergency departments (EDs) in TN was performed between January and April 2009. Data collected included: number and residency training of physicians, ED volume, employment and type of mid-level providers. Survey datawere compared to recent national EM workforce data. Subgroup analysis of rural EDs using Rural-Urban Commuting Area Code (RUCA) criteria was conducted. We received responses from 50 of the 100 emergency departments surveyed. Roughly half (53 percent) were rural, based on RUCA criteria. Mid-level providers worked with physicians in 31 departments, with physician assistants(PAs) being employed more commonly than nurse practitioners(NPs). Paramedics and emergency medical technicians (EMTs) were employed less frequently. Most EM residency trained physicians in Tennessee are working in EDs with approximately 39,000 annual visits per year or greater. Subspecialty physicians such as neurosurgeons, gastroenterologists and otorhinolaryngologists are generally not available to rural EDs, except by patient transfer, illustrating the marked differences in the work environments. While there is clearly a need for more emergency medicine residency training programs in Tennessee, the need to continue to provide advanced training for family medicine residency trained physicians is also clear. Family medicine doctors provide most of the rural emergency medicine in Tennessee.

  9. Professionalism in emergency medicine.

    PubMed

    Finkel, M A; Adams, J G

    1999-05-01

    At its root, medical professionalism is service delivered according to patient's interest. It is essential to reinforce this notion because financial pressures threaten the integrity of the patient-physician relationship. Excessive commercialism directly contrasts the ideals of medical professionalism. This fact necessitates re-examination and reaffirmation of professional behavior. If historical standards of professionalism give way to market-driven incentives, the provision of medical care will become a commodity and the practitioners will be only agents of service delivery. Such a model not only threatens the the physician's identity, but also threatens the patient's interests. Medicine can never succeed as a transaction; it can only succeed as a partnership, a trusting exchange with patients, which is the hallmark of professionalism.

  10. Occupational Emergency Medicine - Introduction

    DTIC Science & Technology

    2011-01-01

    4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be subject to a penalty for failing to comply with...Under Title III, companie covered under the Hazard Communication Standard are r qulred to make their chemica l inventor ies known to emergency response...anagement howe ver. misp)"l’ed . OCClIj1illi.ll1illllleliicilll’ h olli - ia lly, ~ llb ~l)(’ciJ lty of I’rcvellliV l- Illedi cine, which dut’~ ind "d

  11. Virtue in emergency medicine.

    PubMed

    Larkin, Gregory Luke; Iserson, Kenneth; Kassutto, Zach; Freas, Glenn; Delaney, Kathy; Krimm, John; Schmidt, Terri; Simon, Jeremy; Calkins, Anne; Adams, James

    2009-01-01

    At a time in which the integrity of the medical profession is perceptibly challenged, emergency physicians (EPs) have an opportunity to reaffirm their commitment to both their patients and their practice through acceptance of a virtue-based ethic. The virtue-based ethic transcends legalistic rule following and the blind application of principles. Instead, virtue honors the humanity of patients and the high standards of the profession. Recognizing historical roots that are relevant to the modern context, this article describes 10 core virtues important for EPs. In addition to the long-recognized virtues of prudence, courage, temperance, and justice, 6 additional virtues are offered unconditional positive regard, charity, compassion, trustworthiness, vigilance, and agility. These virtues might serve as ideals to which all EPs can strive. Through these, the honor of the profession will be maintained, the trust of patients will be preserved, and the integrity of the specialty will be promoted.

  12. Pre-hospital emergency medicine.

    PubMed

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care.

  13. [Personalized medicine, privatized medicine? legal and public health stakes].

    PubMed

    Rial-Sebbag, Emmanuelle

    2014-11-01

    Personalized medicine is booming. It tends to provide a medical management "tailored" for groups of patients, or for one unique patient, but also to identify risk groups to develop public health strategies. In this context, some radicalization phenomenon can emerge, leading to not only personalized medicine but also privatized medicine, which can lead to a capture of the medical public resource. If the "privatization" of medicine is not limited to producing adverse effects, several potentially destabilizing phenomena for patients still remain. First, some objective factors, like the adjustment of scientific prerequisites, are emerging from personalized medicine practices (clinical trial, public health policy) and are interfering with the medical doctor/patient relationship. Another risk emerges for patients concomitantly to their demand for controlling their own health, in terms of patients' security although these risks are not clearly identified and not effectively communicated. These practices, related to a privatized medicine, develop within the healthcare system but also outside, and the government and legislators will have to take into account these new dimensions in drafting their future regulations and policies.

  14. The evolution of emergency medicine in Ireland.

    PubMed

    Ham, Jason J; Gleeson, Aidan; Reese IV, Charles

    2003-07-01

    Irish emergency medicine is now evolving at a rapid pace. Having roots in a rich Irish medical history and different cultural and economic influences from the United States, the specialty has developed much differently than has American emergency medicine. The history of Irish emergency medicine is discussed and comparisons are made between an Irish and an American emergency department.

  15. [Informed consent in emergency medicine].

    PubMed

    Ersoy, Nermin; Ozcan Senses, Müesser; Aydin Er, Rahime

    2010-01-01

    Informed consent is a prerequisite for the ethical and legal validity of the emergency intervention in emergency medicine, since it protects the fiduciary relationship between the physician and patient; the principle of honesty that grounds this relationship; the principle of autonomy that necessitates right of self-determination; and the principle of respect for persons. Informed consent in emergency medicine, which is supposed to include the nature, benefits and risks of emergency medical intervention, differentiates with respect to definite groups of patients: (1) conscious patients, (2) unconscious patients, and (3) children and mature minors. In addition, informed consent differentiates between medical, psychological and even social circumstances of the patients, referred to as valid consent, expressed-explicit consent, blanket consent, presumed consent, tacit consent, proxy consent, and parental consent. There are a few exceptions in which emergency medical intervention is administered without informed consent. In addition to the exceptions of life-saving interventions, when a patient can not decide for herself/himself, intervention of the physician in the best interest of the patient or children is based on the "therapeutic privilege" of the physician. As an ethically defensible right, since therapeutic privilege may open a door to hard paternalistic approaches, in those situations, emergency physicians should be cautious not to violate a patient's autonomy.

  16. Abstracts from international Emergency Medicine journals.

    PubMed

    Weber, Ellen J

    2017-07-01

    Editor's note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Abstracts from international Emergency Medicine journals.

    PubMed

    Weber, Ellen J

    2017-04-01

    Editor's note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Abstracts from international Emergency Medicine Journals.

    PubMed

    Weber, Ellen J

    2017-03-01

    Editor's note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Top-cited articles in emergency medicine.

    PubMed

    Tsai, Yi-Lun; Lee, Chien-Chang; Chen, Shyr-Chyr; Yen, Zui-Shen

    2006-10-01

    Our purpose was to identify and examine the characteristics of the most frequently cited articles in the field of emergency medicine (EM). Top-cited EM articles in 9 EM journals were identified by searching the computerized database of the Science Citation Index Expanded and the Web of Science (1972 to present). Median citation numbers, authors' nationalities, publication year, and fields of study were described and discussed. Mann-Whitney U and Kruskal-Wallis tests were used to compare groups. All top-cited articles were published during 1972 and 2002. We identified 100 top-cited articles published in 6 EM journals, led by Annals of Emergency Medicine (66) and American Journal of Emergency Medicine (22). Toxicology, traumatology, resuscitation medicine, and cardiovascular medicine were the primary focus of study. The median citation number for these top-cited articles was 102 (range, 71-335). Our analysis gives an encyclopedic review of citation frequency of top-cited articles published in EM journals, which may provide information for those who want to find the history, evolution, and areas of high-impact research activities of EM.

  20. Emergency medicine and environmental activism.

    PubMed

    Couser, Geoff

    2004-01-01

    Clearfell, burn and sow silviculture is promoted as being the most scientific method of harvesting wet sclerophyll forests in Tasmania. However, it fails to take into account wider social and global environmental issues such as climate change and the carbon cycle. This paper describes an emergency physician's role in the continuing debate surrounding the management of Tasmania's old-growth forests. Like evidence-based medicine, the use of science in this context has its limitations, and such comparisons are discussed.

  1. A Cost-Effective Emergency Medicine Clerkship.

    ERIC Educational Resources Information Center

    Shesser, Robert; And Others

    1985-01-01

    Programs in emergency medicine are expected to become increasingly organized with the development of emergency medicine teaching faculties. A clerkship design with clinical instruction, classroom instruction, and evaluation is described. (Author/MLW)

  2. Emergency medicine narratives: a systematic discussion of definition and utility.

    PubMed

    Hawkins, Seth Collings

    2004-07-01

    A substantial number of emergency medicine providers are publishing stories and other creative expressions related to their medical experiences. This is a systematic review of such publications, introduces the term "emergency medicine narratives" to describe such pieces, and proposes a framework to classify the various forms of expression. Specifically, six genres of emergency medicine narratives are discussed: medical autobiography, clinical narratives, creative narratives, out-of-hospital narratives, lay exposition, and photojournalism. This review explores the utility of these narratives and the role they play within the field of emergency medicine, provides a bibliography of emergency narratives, and suggests future questions that might be addressed regarding this growing phenomenon in the field of emergency medicine.

  3. Publication productivity in nuclear medicine.

    PubMed

    McKellar, Cheryl; Currie, Geoff

    2015-06-01

    Publications form the knowledge base of any profession. Patterns in professional publications provide insight into the profession's maturity and global status. To our knowledge, publication productivity in nuclear medicine technology has not been reported. A recent study on publication productivity in radiography and radiation therapy provided interesting insight; however, a sampling bias resulted in study flaws. The most productive medical radiation technologists were determined by collecting data from 7 key, international peer-reviewed journals for the medical radiation sciences over a 5-y period. A full list of the technologists' publications, for the 5-y period, was obtained using a PubMed and ResearchGate search, and the authors were analyzed. In total, 165 medical radiation technologists were identified who had published 3 or more articles between 2009 and 2013. Of these authors, 55.2% (91/165) were radiographers, 35.2% (58/165) were radiation therapists, and 9.6% (16/165) were nuclear medicine technologists. Overall, the majority of the most prolific authors were academics (104/165; 63.0%). After we applied a correction factor (the productivity per member of the registered workforce), radiography had the fewest authors publishing, compared with the relative workflow sizes. Nuclear medicine technologists demonstrated a high degree of productivity both absolutely and relatively. Consequently, nuclear medicine technologists have a productive research culture and command a large footprint within and outside the key medical radiation science journals. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  4. Curriculum for Undergraduate Education in Emergency Medicine.

    ERIC Educational Resources Information Center

    Brown, Charles G.; And Others

    1984-01-01

    As emergency medicine became a specialty, it was realized that traditional training of physicians in urgent, emergent, and acute care problems was deficient. Surveys and studies demonstrate that the emergency medicine curricula in American medical schools remains at a minimum. (MLW)

  5. Research in emergency medicine in Europe.

    PubMed

    Miró, O Scar; Burillo-Putze, Guillermo

    2012-04-01

    Health research is fundamental for clinical excellence, a fact that applies equally to emergency medicine (EM). Although European scientific publication rates in EM have traditionally been lower than those of other medical specialties, from 1995 steady progress has been made. To increase the scientific output in EM it is necessary to resolve issues that hinder this progress, including the fact that EM is a new specialty, or even nonexistent in many European countries. This has resulted in a relative lack of scientific culture and training in research methodology of emergency physicians, of explicit recognition of scientific work, or of emergency physician competitiveness to apply to national and European grants for research projects. In addition, it is necessary to improve representation of European journals indexed in the category of EM and to receive a firm boost to EM research from the European Society for Emergency Medicine as well as from all European national societies. This study reviews these aspects and offers a personal perspective on where European EM research should be going.

  6. Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

    PubMed

    Baskin, Sean M; Lin, Christina; Carlson, Jestin N

    2014-11-01

    Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.

  7. Emergency medicine in the United Arab Emirates

    PubMed Central

    2014-01-01

    It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as consultants overseeing care. Prehospital care and emergency medical services (EMS) operate under the auspices of the police department. Standardized protocols have been established for paramedic certification, triage, and destination decisions. The majority of ambulances offer basic life support (BLS/Type 2) with a growing minority offering advanced life support (ALS/Type 3). Medicine residency programs were established 5 years ago and form the foundation for training emergency medicine specialists for UAE. This article describes the full spectrum of emergency medicine in the UAE: prehospital care, EMS, hospital-based emergency care, training in emergency medicine, and disaster preparedness. We hope that our experience, our understanding of the challenges faced by the specialty, and the anticipated future directions will be of importance to others advancing emergency medicine in their region and across the globe. PMID:24401695

  8. [Assistance medicine, a novel discipline of emergency medicine].

    PubMed

    Felkai, Péter

    2015-05-17

    The number of international travels has been continuously increasing since World War II. Though the travelers' demand for safer ways of travelling appeared, only a handful of them sought pretravel advices. This is the reason why 50% of the travelers have to face some kind of medical problem during their journey. If they have travel insurance, the company's assistance team organizes, monitors and covers their abroad treatment. A doctor of the assistance team has to find her/his ways in various fields: not only a multidisciplinary medical knowledge is a must for a professional like this, but she/he needs to have a good grasp of the basic idea behind the insurance policy, too. Also, she/he should be familiar with the public health care systems of different countries and some legal knowledge is also needed. If the patients are unable to continue their trip, they must be repatriated. Making a decision about the repatriation's timing and modality requires interdisciplinary medical experience and the approach of a critical care/emergency doctor. Among further tasks for the assistance team's doctor one can find medical escort and on-spot medical visit for foreign patients. Both of these two aforementioned medical activities are highly different from - for example - a general practitioner's routine. That is the reason why an assistance doctor has to be familiar with the critical and emergency care. Organizing and monitoring medical treatment for a traveler abroad, providing medical escort, making decisions about repatriation and providing medical help for a foreign patient all fall within the competence of a new medical discipline, the assistance medicine. Creating a body of knowledge, collecting appropriate protocols and establishing postgraduate courses for assistance medicine diplomas are the tasks of the critical care and emergency medicine professionals.

  9. Society for Academic Emergency Medicine Statement on Plagiarism.

    PubMed

    Asher, Shellie L; Iserson, Kenneth V; Merck, Lisa H

    2017-06-19

    The integrity of the research enterprise is of the utmost importance for the advancement of safe and effective medical practice for patients and for maintaining the public trust in health care. Academic societies and editors of journals are key participants in guarding scientific integrity. Avoiding and preventing plagiarism helps to preserve the scientific integrity of professional presentations and publications. The Society for Academic Emergency Medicine (SAEM) Ethics Committee discusses current issues in scientific publishing integrity and provides a guideline to avoid plagiarism in SAEM presentations and publications. © 2017 by the Society for Academic Emergency Medicine.

  10. Human factors and simulation in emergency medicine.

    PubMed

    Hayden, Emily M; Wong, Ambrose H; Ackerman, Jeremy; Sande, Margaret K; Lei, Charles; Kobayashi, Leo; Cassara, Michael; Cooper, Dylan D; Perry, Kimberly; Lewandowski, William E; Scerbo, Mark W

    2017-09-19

    This consensus group from the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes" held in Orlando, Florida on May 16, 2017 focused on the use of human factors and simulation in the field of emergency medicine. The human factors discipline is often underutilized within emergency medicine but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of human factors, its benefits in medicine, how simulation can be a catalyst for human factors work in emergency medicine, and how emergency medicine can collaborate with human factors professionals to affect change. Implementing human factors in emergency medicine through healthcare simulation will require a demonstration of clinical and safety outcomes, advocacy to stakeholders and administrators, and establishment of structured collaborations between human factors professionals and emergency medicine, such as in this breakout group. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Emergency medicine: beyond the basics.

    PubMed

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  12. The Emergency Medicine Workforce: Profile and Projections.

    PubMed

    Reiter, Mark; Wen, Leana S; Allen, Brady W

    2016-04-01

    The landscape of the emergency medicine workforce has changed dramatically over the last few decades. The growth in emergency medicine residency programs has significantly increased the number of emergency medicine specialists now staffing emergency departments (EDs) throughout the country. Despite this increase in available providers, rising patient volumes, an aging population, ED overcrowding and inefficiency, increased regulation, and other factors have resulted in the continued need for additional emergency physicians. To review current available data on patient volumes and characteristics, the overall physician workforce, the current emergency physician workforce, the impact of physician extenders and scribes on the practice of emergency medicine, and project emergency physician staffing needs into the future. We project that within the next 5 to 10 years, there will be enough board-certified or -eligible emergency physicians to provide care to all patients in the U.S. EDs. However, low-volume rural EDs will continue to have difficulty attracting emergency medicine specialists without significant incentives. There remains a shortage of board-certified emergency physicians, but it is decreasing every year. The use of physicians from other specialties to staff EDs has long been based on the theory that there is a long-standing shortage of available American Board of Emergency Medicine/American Osteopathic Board of Emergency Medicine physicians, both now and in the future. Our investigation shows that this is not supported by current data. Although there will always be regional and rural physician shortages, these are mirrored by all other specialties and are even more pressing in primary care. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. [Internal medicine and public health].

    PubMed

    2009-08-01

    A special Committee on Internal Medicine and Public Health was established by Sociedad Médica de Santiago (Chilean Society of Internal Medicine) in April 2007 with the duty to write a Consensus Paper on the interaction between both branches of medical profession. The main objective was to find the common grounds on which to construct a positive approach to regain space for Internal Medicine, based on prevalent epidemiológical features related to adult health issues. The authors describe the reasons to explain the gap between clinical medicine and population health and identify the nature and evolution of chronic diseases as the point of encounter between both. With Chilean health surveys data, they state that chronic diseases explain the high proportion of burden of disease, mortality and disability, and stress that by the year 2025 one in every five inhabitants will be over 65 years of age, with ageing as another main problem for the health care sector. Population with multiple risks and multimorbidity is the most important challenge for the Chilean Health Care System. A new model of care is needed to tackle this scenario with new skills regarding psychosocial determinants of health. The leading role of internists and ideally geriatricians, will be crucial in this process and will help the implementation of sound population based interventions. Both individual and community level interventions will help to improve quality of life of Chilean families.

  14. State of emergency medicine in Spain

    PubMed Central

    2010-01-01

    Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care centers (PCC), in an extrahospital setting by emergency medical services (EMS) and at hospital emergency departments (ED). We have more than 3,000 PCCs, which are run by family doctors (general practitioners) and pediatricians. On average, there is 1 PCC for every 15,000 to 20,000 inhabitants, and every family doctor is in charge of 1,500 to 2,000 citizens, although less populated zones tend to have lower ratios. Doctors spend part of their duty time in providing emergency care to their own patients. While not fully devoted to emergency medicine (EM) practice, they do manage minor emergencies. However, Spanish EMSs contribute hugely to guarantee population coverage in all situations. These EMS are run by EM technicians (EMT), nurses and doctors, who usually work exclusively in the emergency arena. EDs dealt with more than 25 million consultations in 2008, which implies, on average, that one out of two Spaniards visited an ED during this time. They are usually equipped with a wide range of diagnostic tools, most including ultrasonography and computerized tomography scans. The academic and training background of doctors working in the ED varies: nearly half lack any structured specialty residence training, but many have done specific master or postgraduate studies within the EM field. The demand for emergency care has grown at an annual rate of over 4% during the last decade. This percentage, which was greater than the 2% population increase during the same period, has outpaced the growth in ED capacity. Therefore, Spanish EDs become overcrowded when the system exerts minimal stress. Despite the high EM caseload and the potential severity of the conditions, training in EM is still unregulated in Spain. However, in April 2009 the Spanish Minister of Health

  15. Emergency medicine: A comprehensive review

    SciTech Connect

    Kravis, T.C.; Warner, C.G.

    1987-01-01

    This book contains 91 chapters divided among 14 sections. Some of the chapter titles are: Transfusions; Minor Lacerations and Abrasions; Diabetic Emergencies; Adrenal Insufficiency; Hypercalcemia; Medical Genetics; Burns; Hazardous Materials; Gastrointestinal Emergencies; Infectious Disease Emergencies; Reye's Syndrome; Bites and Stings; and Hypothermia.

  16. Faculty Mentoring Practices in Academic Emergency Medicine.

    PubMed

    Welch, Julie; Sawtelle, Stacy; Cheng, David; Perkins, Tony; Ownbey, Misha; MacNeill, Emily; Hockberger, Robert; Rusyniak, Daniel

    2017-03-01

    Mentoring is considered a fundamental component of career success and satisfaction in academic medicine. However, there is no national standard for faculty mentoring in academic emergency medicine (EM) and a paucity of literature on the subject. The objective was to conduct a descriptive study of faculty mentoring programs and practices in academic departments of EM. An electronic survey instrument was sent to 135 department chairs of EM in the United States. The survey queried faculty demographics, mentoring practices, structure, training, expectations, and outcome measures. Chi-square and Wilcoxon rank-sum tests were used to compare metrics of mentoring effectiveness (i.e., number of publications and National Institutes of Health [NIH] funding) across mentoring variables of interest. Thirty-nine of 135 departments completed the survey, with a heterogeneous mix of faculty classifications. While only 43.6% of departments had formal mentoring programs, many augmented faculty mentoring with project or skills-based mentoring (66.7%), peer mentoring (53.8%), and mentoring committees (18%). Although the majority of departments expected faculty to participate in mentoring relationships, only half offered some form of mentoring training. The mean number of faculty publications per department per year was 52.8, and 11 departments fell within the top 35 NIH-funded EM departments. There was an association between higher levels of perceived mentoring success and both higher NIH funding (p = 0.022) and higher departmental publications rates (p = 0.022). In addition, higher NIH funding was associated with mentoring relationships that were assigned (80%), self-identified (20%), or mixed (22%; p = 0.026). Our findings help to characterize the variability of faculty mentoring in EM, identify opportunities for improvement, and underscore the need to learn from other successful mentoring programs. This study can serve as a basis to share mentoring practices and stimulate

  17. International emergency medicine: a review of the literature from 2009.

    PubMed

    Foran, Mark; Levine, Adam; Lippert, Suzanne; Chan, Jennifer; Aschkenasy, Miriam; Arnold, Kris; Rosborough, Stephanie

    2011-01-01

    As the specialty of emergency medicine evolves in countries around the world, and as interest in international emergency medicine (IEM) grows within the United States, the IEM Literature Review Group recognizes an ongoing need for a high-quality, consolidated, and easily accessible evidence base of literature. The IEM Literature Review Group produces an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research from the previous year. This publication represents our fifth annual review, covering the top 24 IEM research articles published in 2009. Articles were selected for the review according to explicit, predetermined criteria that emphasize both methodologic quality and impact of the research. It is our hope that this annual review acts as a forum for disseminating best practices, while also stimulating further research in the field of IEM. © 2010 by the Society for Academic Emergency Medicine.

  18. American Board of Emergency Medicine report on residency training information (2013-2014), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Baren, Jill M; Beeson, Michael S; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C

    2014-05-01

    The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs.

  19. American Board of Emergency Medicine report on residency training information (2012-2013), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Baren, Jill M; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Wahl, Robert P; Korte, Robert C

    2013-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2013 annual report on the status of US emergency medicine training programs.

  20. Core curricular elements for fellowship training in international emergency medicine.

    PubMed

    Bayram, Jamil; Rosborough, Stephanie; Bartels, Susan; Lis, Julian; VanRooyen, Michael J; Kapur, G Bobby; Anderson, Philip D

    2010-07-01

    The objective was to describe the common educational goals, curricular elements, and methods of evaluation used in international emergency medicine (IEM) fellowship training programs currently. IEM fellowship programs have been developed to provide formal training for emergency physicians (EPs) interested in pursuing careers in IEM. Those fellowships are variable in scope, objectives, and duration. Previously published articles have suggested a general curriculum structure for IEM fellowships. A search of MEDLINE, EMBASE, and CINAHL databases from 1950 to June 2008 was performed, combining the terms international, emergency medicine, and fellowship. Online curricula and descriptive materials from IEM fellowships listed by the Society for Academic Emergency Medicine (SAEM) were reviewed. Knowledge and skill areas common to multiple programs were organized in discrete categories. IEM fellowship directors were contacted for input and feedback. Eight articles on IEM fellowships were identified. Two articles described a general structure for fellowship curriculum. Sixteen of 20 IEM fellowship programs had descriptive materials posted online. These information sources, plus input from seven fellowship program directors, yielded the following seven discrete knowledge and skill areas: 1) emergency medicine systems development, 2) humanitarian relief, 3) disaster management, 4) public health, 5) travel and field medicine, 6) program administration, and 7) academic skills. While IEM fellowships vary with regard to objectives and structure, this article presents an overview of the current focus of IEM fellowship training curricula that could serve as a resource for IEM curriculum development at individual institutions. 2010 by the Society for Academic Emergency Medicine

  1. A Multidisciplinary Clerkship in Emergency Medicine.

    ERIC Educational Resources Information Center

    And Others; Marshall, Carter L.

    1979-01-01

    At the New Jersey Medical School, an obligatory, multidisciplinary, fourth-year emergency medicine clerkship requires ambulance duty, emergency room rotation, medical specialty lectures, and a cardiac life support providers course. Particular problems associated with multidisciplinary courses are discussed. (Author/JMD)

  2. Emerging trends in antibiotic resistance: Implications for emergency medicine.

    PubMed

    Pourmand, Ali; Mazer-Amirshahi, Maryann; Jasani, Gregory; May, Larissa

    2017-08-01

    Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database. The following bacteria were included: methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, Escherichia coli, carbapenem-resistant Enterobacteriaceae, Neisseria gonorrhoeae, and Pseudomonas aeruginosa. All have shown increasing rates of resistance to one or more of the antibiotics commonly used to treat them. Increasing rates of antibiotic resistance are associated with worse clinical outcomes and greater healthcare costs. Antibiotic resistance is increasing and poses significant a risk to both the patient and public health as a whole. Appropriate choice of initial antibiotic is important in improving clinical outcomes, which is often the role of the ED provider. On a broader level, the ED must also take part in institutional efforts such as Antibiotic Stewardship Programs, which have been shown to decrease costs and rates of infection with resistant organisms. Ultimately, a multifaceted approach will be required to curb the threat of antibiotic-resistant bacteria. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Anaesthesia and pre-hospital emergency medicine.

    PubMed

    Booth, A; Steel, A; Klein, J

    2013-01-01

    Major trauma is a leading cause of death and disability in the UK, particularly in the young. Pre-hospital emergency medicine (PHEM) involves provision of immediate medical care to critically ill and injured patients, across all age ranges, often in environments that may be remote and are not only physically challenging but also limited in terms of time and resources. PHEM is now a GMC-recognised subspecialty of anaesthesia or emergency medicine and the first recognised training program in the UK commenced in August 2012. This article discusses subspeciality development in PHEM, the competency based framework for training in PHEM, and the provision of pre-hospital emergency anaesthesia.

  4. National health reform and emergency medicine.

    PubMed

    Williams, R M

    1993-01-01

    I accept the responsibility of the office of President of ACEP today with great pride--not in myself at having achieved this prestigious office, but rather in the specialty of emergency medicine. I am honored to have the privilege and pleasure of your association and support, and I am immensely proud of being an emergency physician. I have presented these ideas and challenges in a spirit of enthusiasm and optimism for emergency medicine and ACEP. Innovation, courage, and determination are our heritage and will hopefully forever be our legacy. Emergency physicians truly are on the leading edge of the great issues of our society. I believe the time has come for us to assume a leadership position in medicine that reflects the dedication, compassion, and pioneering spirit on which this specialty was founded nearly 25 years ago--and which is so evident in this room today. Please join me in this exciting and worthwhile endeavor.

  5. Space medicine research publications: 1984-1986

    NASA Technical Reports Server (NTRS)

    Wallace, Janice S.

    1988-01-01

    A list is given of the publications of investigators supported by the Biomedical Research and Clinical Medicine Programs of the Space Medicine and Biology Branch, Life Sciences Division, Office of Space Science and Applications. It includes publications entered into the Life Sciences Bibliographic Database by the George Washington University as of December 31, 1986. Publications are organized into the following subject areas: Clinical Medicine, Space Human Factors, Musculoskeletal, Radiation and Environmental Health, Regulatory Physiology, Neuroscience, and Cardiopulmonary.

  6. Bedside ultrasound in pediatric emergency medicine.

    PubMed

    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

  7. State of emergency medicine in Azerbaijan.

    PubMed

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-04-01

    There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

  8. Emerging technologies in aesthetic medicine.

    PubMed

    Reddy, Bobby Y; Hantash, Basil M

    2009-10-01

    Recent advances in technology have drastically improved aesthetic treatment for skin. Of particular interest is the emergence of laser- and lightbased technologies, which have offered great promise among skin-rejuvenation therapies. New laser resurfacing techniques for skin rejuvenation offer significant advantages over conventional ablative lasers, such as the CO(2) and erbiumYAG laser systems. Nonablative and fractional lasers, although not as efficacious as ablative therapies, are associated with significantly diminished complication rates and shortened recovery times. Novel devices combining ablative and fractional technologies have also surfaced, demonstrating noteworthy results. In this review, the authors will discuss the implications of current developments in research and technology for skin rejuvenation. Furthermore, the authors will address emerging therapies for acne vulgaris, lipolysis, and cellulite.

  9. Approach to Reptile Emergency Medicine.

    PubMed

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients.

  10. A research agenda for geriatric emergency medicine.

    PubMed

    Wilber, Scott T; Gerson, Lowell W

    2003-03-01

    The Research Agenda Setting Process (RASP), part of the American Geriatric Society's (AGS's) project "Increasing Geriatric Expertise in Surgical and Related Medical Specialties," was designed to define a research agenda for the geriatrics aspects of participating specialties. This paper presents a summary of the research agenda for emergency medicine. The RASP was developed by the AGS in conjunction with experts from the participating specialty organizations. A "content expert" (CE) for each specialty developed a Medline search strategy in conjunction with RAND Health librarians. The CE reviewed the search to identify papers that were germane to research in the emergency care of older patients. The CE and a senior writing group member drafted a paper that synthesized the current literature and suggested areas for further research. A panel consisting of AGS members and emergency physicians with geriatrics expertise reviewed this paper. The research agenda was further refined at a two-day retreat. Two senior geriatricians reviewed the resulting paper. The Medline search for emergency medicine resulted in a list of 3,348 articles; 299 articles were pertinent and reviewed. The search for trauma resulted in a list of 1,838 articles; 133 were reviewed. Research agenda items were defined for multiple topics within geriatric emergency medicine and trauma. A research agenda for geriatric emergency medicine has been developed, using a combination of review of current literature and expert opinion.

  11. Female representation on emergency medicine editorial teams.

    PubMed

    Miró, Oscar; Burillo-Putze, Guillermo; Plunkett, Patrick K; Brown, Anthony F T

    2010-04-01

    To analyse the presence of women on the editorial teams of emergency medicine journals and the potential relationship between the pre-eminence of the journal and their presence. In this cross-sectional study, we examined 10 journals cited under the heading of 'Emergency Medicine' by Thomson Scientific in the Journal Citation Reports and 14 additional emergency journals not cited but which publish investigations in emergency medicine. We evaluated the editorial board posted on their websites, determining the number of men and women occupying executive tasks, as well as the sex of the editor-in-chief of each journal. We identified 372 people working on the editorial teams (mean: 15.5, SD: 13.5), 49 being women (13.2%). Of these 372 people, 28 were editors-in-chief but only one was female (3.6%). We found no statistical differences between indexed and nonindexed emergency journals regarding female representation on the editorial team or in the position of editor-in-chief. Neither did we find any relationship between female presence and the pre-eminence of the indexed journals using impact factor as a surrogate marker. Very few women are found either on editorial teams or in editor-in-chief positions in the emergency medicine journals, irrespective of the pre-eminence of the journal. It should be investigated whether a negative journal bias underlies these findings.

  12. Conflicts of Interest in Emergency Medicine.

    PubMed

    Geiderman, Joel Martin; Iserson, Kenneth V; Marco, Catherine A; Jesus, John; Venkat, Arvind

    2017-07-08

    Conflicts of interest are common in the practice of emergency medicine and may be present in the areas of clinical practice, relations with industry, expert witness testimony, medical education, research, and organizations. A conflict of interest occurs when there is dissonance between a primary interest and another interest. The concept of professionalism in medicine places the patient as the primary interest in any interaction with a physician. We contend that patient welfare is the ultimate interest in the entire enterprise of medicine. Recognition and management of potential, real and perceived conflicts of interest are essential to the ethical practice of emergency medicine. This paper discusses how to recognize, address, and manage them. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Emergency Medicine Gender-specific Education.

    PubMed

    Ashurst, John V; McGregor, Alyson J; Safdar, Basmah; Weaver, Kevin R; Quinn, Shawn M; Rosenau, Alex M; Goyke, Terrence E; Roth, Kevin R; Greenberg, Marna R

    2014-12-01

    The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex- and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described. © 2014 by the Society for Academic Emergency Medicine.

  14. Space medicine research publications: 1983-1984

    NASA Technical Reports Server (NTRS)

    Solberg, J. L.; Pleasant, L. G.

    1984-01-01

    A list of publications supported by the Space Medicine Program, Office of Space Science and Applications is given. Included are publications entered into the Life Sciences Bibliographic Database by The George Washington University as of October 1, 1984.

  15. International emergency medicine: a review of the literature from 2007.

    PubMed

    Levine, Adam C; Becker, Joseph; Lippert, Suzanne; Rosborough, Stephanie; Arnold, Kris

    2008-09-01

    The subspecialty of international emergency medicine (IEM) continues to grow within the United States, just as the specialty of emergency medicine (EM) continues to spread to both developed and developing countries around the world. One of the greatest obstacles, however, faced by IEM researchers and practitioners alike, remains the lack of a high-quality, consolidated, and easily accessible evidence-base of literature. In response to this perceived need, members of the Emergency Medicine Resident Association (EMRA) International Emergency Medicine Committee, in conjunction with members of the Society for Academic Emergency Medicine (SAEM) International Health Interest Group, have embarked on the task of creating a recurring review of IEM literature. This publication represents the third annual review, covering the top 30 IEM research articles published in 2007. Articles were selected for the review according to explicit, predetermined criteria that included both methodologic quality and perceived impact of the research. It is hoped that this annual review will act as a forum for disseminating best practices, while also stimulating further research in the field of IEM.

  16. Night shifts in emergency medicine: the american board of emergency medicine longitudinal study of emergency physicians.

    PubMed

    Smith-Coggins, Rebecca; Broderick, Kerryann B; Marco, Catherine A

    2014-09-01

    Night shift work is an integral component of the practice of emergency medicine (EM). Previous studies have demonstrated the challenges of night shift work to health and well being among health care providers. This study was undertaken to describe the self-reported experience of emergency physicians regarding night shift work with respect to quality of life and career satisfaction. The 2008 American Board of Emergency Medicine (ABEM) Longitudinal Study of Emergency Physicians (LSEP) was administered by mail to 1003 ABEM diplomates. Among 819 participants in the 2008 LSEP Physician Survey, most participants responded that night shift work negatively influenced job satisfaction with a moderate or major negative influence (58%; n = 467/800). Forty-three percent of participants indicated that night shifts had caused them to think about leaving EM (n = 344/809). Most participants responded that working night shifts has had mild negative effects (51%; n = 407/800) or major negative effects (9%; n = 68) on their health. Respondents were asked to describe how working night shifts has affected their health. Common themes included fatigue (36%), poor quality of sleep (35%), mood decrement/irritability (29%), and health maintenance challenges (19%). Among participants in the 2008 LSEP Retired Physician Survey, night shifts were a factor in the decision to retire for 56% of participants. Emergency physicians report negative impacts of night shift work, including fatigue, poor quality of sleep, mood decrement, irritability, and health challenges. Night shifts have a negative influence on job satisfaction and can be a factor in the decision to retire. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Identifying inaccuracies on emergency medicine residency applications

    PubMed Central

    Katz, Eric D; Shockley, Lee; Kass, Lawrence; Howes, David; Tupesis, Janis P; Weaver, Christopher; Sayan, Osman R; Hogan, Victoria; Begue, Jason; Vrocher, Diamond; Frazer, Jackie; Evans, Timothy; Hern, Gene; Riviello, Ralph; Rivera, Antonio; Kinoshita, Keith; Ferguson, Edward

    2005-01-01

    Background Previous trials have showed a 10–30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. Methods This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans and the NRMP. Results Nine residencies reviewed 493 applications (28.6% of all applicants who applied to any EM program). 56 applications (11.4%, 95%CI 8.6–14.2%) contained at least one error. Excluding "benign" errors, 9.8% (95% CI 7.2–12.4%), contained at least one error. 41% (95% CI 35.0–47.0%) of all publications contained an error. All AOA membership claims were verified, but 13.7% (95%CI 4.4–23.1%) of claimed advanced degrees were inaccurate. Inter-rater reliability of evaluations was good. Investigators were reluctant to notify applicants' dean's offices and the NRMP. Conclusion This is the largest study to date of accuracy on application for residency and the first such multi-centered trial. High rates of incorrect data were found on applications. This data will serve as a baseline for future years of the project, with emphasis on reporting inaccuracies and warning applicants of the project's goals. PMID:16105178

  18. Evaluation of Emergency Medicine Residents by Nurses.

    ERIC Educational Resources Information Center

    Tintinalli, Judith E.

    1989-01-01

    Emergency medicine residents at William Beaumont Hospital are evaluated quarterly by the nursing staff. The nurses discuss each resident and reach consensus on each evaluation item and copies are given to each resident. Although the residents' attitudes have not been favorable, overall their behavioral interactions have improved markedly.…

  19. The top 100 cited articles published in emergency medicine journals.

    PubMed

    Shuaib, Waqas; Acevedo, Javier N; Khan, Muhammad Shahzeb; Santiago, Luis J; Gaeta, Theodore J

    2015-08-01

    Our objective was to identify trends and examine the characteristics of the top 100 cited articles in emergency medicine (EM) journals. Scopus Library database was queried to determine the citations of the top 100 EM articles. A second database (Google Scholar) was used to gather the following information: number of authors, publication year, journal name, impact factor, country of origin, and article type (original article, review article, conference paper, or editorial). The top 100 cited articles were selected and analyzed by 2 independent investigators. We identified 100 top-cited articles published in 6 EM journals, led by Annals of Emergency Medicine (65) and American Journal of Emergency Medicine (15). All top-cited articles were published between 1980 and 2009. The common areas of study were categorized as cardiovascular medicine, emergency department administration, toxicology, pain medicine, pediatrics, traumatology, and resuscitation. A statistically significant association was found between the journal impact factor and the number of top 100 cited articles (P < .005). The top-cited articles published in EM journals help us recognize the quality of the works, discoveries, and trends steering EM. Our analysis provides an insight to the prevalent areas of study being cited within our field of practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Aspects of higher training in emergency medicine

    PubMed Central

    Kilroy, D

    2003-01-01

    Objectives: To devise and develop a structured questionnaire addressing important issues relating to specialist registrar training in emergency medicine in the UK, and to then administer this questionnaire nationally to higher trainees in order to establish current practice and opinion regarding those issues. Methods: Informal interviews with current trainees were undertaken to identify themes which might be of wider importance in relation to training. The transcriptions were incorporated into a discussion questionnaire which was circulated to other trainees and to members of the Joint Committee on Higher Training in Accident and Emergency. A postal survey was developed from this draft and distributed to all trainees currently registered with the Faculty of Accident and Emergency Medicine. Results: The response rate was 75%. Collective responses to certain aspects of training are demonstrated in order to reflect current practice and opinion among UK specialist registrars and to allow further debate. Conclusion: Development of a structured questionnaire allows issues in relation to training in emergency medicine to be assessed. The findings of the survey allow national data to be presented which will be of interest to trainees and trainers in the UK as well as overseas. PMID:12954958

  1. International emergency medicine: a review of the literature from 2008.

    PubMed

    Lippert, Suzanne; Levine, Adam C; Becker, Joseph; Foran, Mark; Rosborough, Stephanie; Arnold, Kris

    2009-12-01

    As the specialty of emergency medicine (EM) continues to evolve in countries around the world, and as interest in international emergency medicine (IEM) continues to grow within the United States, the IEM Literature Review Group recognizes a need for a high-quality, consolidated, and easily accessible evidence base of literature. In response to that need, the group created an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research. This publication represents our fourth annual review, covering the top 26 IEM research articles published in 2008. Articles were selected for the review according to explicit, predetermined criteria that include both methodologic quality and perceived impact of the research. It is our hope that this annual review will act as a forum for disseminating best practices while also stimulating further research in the field of IEM.

  2. [Evolutionary medicine: an emergent basic science].

    PubMed

    Spotorno, Angel E

    2005-02-01

    Evolutionary Medicine is an emergent basic science that offers new and varied perspectives to the comprehension of human health. The application of classic evolutionary theories (descent with modification, and natural selection) to the human organism, to its pathogens, and their mutual co-evolution, provides new explanations about why we get sick, how we can prevent this, and how we can heal. Medicine has focused mainly on the proximate or immediate causes of diseases and the treatment of symptoms, and very little on its evolutionary or mediate causes. For instance, the present human genome and phenotypes are essentially paleolithic ones: they are not adapted to modern life style, thus favoring the so-called diseases of civilization (ie: ateroesclerosis, senescence, myopia, phobias, panic attacks, stress, reproductive cancers). With the evolutionary approach, post-modern medicine is detecting better the vulnerabilities, restrictions, biases, adaptations and maladaptations of human body, its actual diseases, and its preventions.

  3. Queensland Emergency Medicine Research Foundation: special report.

    PubMed

    FitzGerald, Gerry; Codd, Catrina; Aitken, Peter; Sinnott, Michael

    2012-02-01

    Development of any new profession is dependent on the development of a special body of knowledge that is the domain of the profession. Key to this is research. Following sustained lobbying, the Queensland Government agreed to establish an emergency medicine research fund as part of an Enterprise Bargaining Agreement in 2006. That fund is managed by the Queensland Emergency Medicine Research Foundation. The present article describes the strategic approaches of the Foundation in its first 3 years, the application of research funds, and foreshadows an evaluative framework for determining the strategic value of this investment. The Foundation has developed a range of personnel and project support funding programmes, and competition for funding has increased. Ongoing evaluation will seek to determine the effectiveness of the current funding strategy on improving the effectiveness of research performance. It will also evaluate the clinical and organizational outcomes.

  4. Dissemination and implementation research in emergency medicine.

    PubMed

    Bernstein, Steven L; Stoney, Catherine M; Rothman, Richard E

    2015-02-01

    Published medical research takes years to change clinical practice. The reasons for this evidence-to-practice gap are many. To address this gap, in recent years the field of dissemination and implementation (D&I) science has grown dramatically. D&I studies design and test strategies to accelerate the movement of new evidence-based diagnostic and therapeutic maneuvers into real-world clinical practice. This article summarizes the proceedings of sessions at the 2011 and 2012 annual meetings of the Society for Academic Emergency Medicine that discussed D&I studies in emergency medicine. Examples of current studies are provided, along with a review of D&I methods, funding opportunities, and suggestions for future research.

  5. Human factors and safety in emergency medicine

    NASA Technical Reports Server (NTRS)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  6. Human factors and safety in emergency medicine

    NASA Technical Reports Server (NTRS)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  7. Space medicine research publications: 1987-1988

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A list of publications of investigators supported by the Biomedical Research and Clinical Programs of the Life Sciences Division, Office of Space Science and Applications is given. Included are publications entered into the Life Sciences Bibliographic Database by the George Washington University as of 31 December 1988. Principal Investigators whose research tasks resulted in publication are identified by asterisk. Publications are organized into the following subject areas: space physiology and countermeasures (cardiopulmonary, musculoskeletal, neuroscience, and regulatory physiology), space human factors, environmental health, radiation health, clinical medicine, and general space medicine.

  8. Identifying public health competencies relevant to family medicine.

    PubMed

    Harvey, Bart J; Moloughney, Brent W; Iglar, Karl T

    2011-10-01

    Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. Using a multi-staged, iterative process that included a detailed literature review, the authors developed a set of public health competencies relevant to primary care, identifying competencies relevant across four levels, from "post-MD" to "enhanced." Feedback from family medicine and public health educator-practitioners regarding the set of proposed "essential" competencies indicated the need for a more limited, feasible set of "priority" areas to be highlighted during residency training. This focused set of public health competencies has begun to guide relevant components of the University of Toronto's Family Medicine Residency Program curriculum, including academic half-days; clinical experiences, especially identifying "teachable moments" during patient encounters; resident academic projects; and elective public health agency placements. These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent.

  9. Microfinance as a method of facilitating research in emergency medicine.

    PubMed

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2010-04-22

    Microgrants are a novel concept where small grants are used to facilitate research. The concept might have a place in developing emergency medicine research, especially in countries where emergency medicine is not established or in new areas of research. Two examples of the beneficial effects of microgrants in emergency medicine research are described. Emergency medicine interest groups and foundations should consider setting up microgrant schemes.

  10. Microfinance as a method of facilitating research in emergency medicine

    PubMed Central

    2010-01-01

    Microgrants are a novel concept where small grants are used to facilitate research. The concept might have a place in developing emergency medicine research, especially in countries where emergency medicine is not established or in new areas of research. Two examples of the beneficial effects of microgrants in emergency medicine research are described. Emergency medicine interest groups and foundations should consider setting up microgrant schemes. PMID:20412571

  11. Emergency medicine techniques and the forensic autopsy.

    PubMed

    Buschmann, Claas; Schulz, Thomas; Tsokos, Michael; Kleber, Christian

    2013-03-01

    Emergency medicine measures often have to be carried out under suboptimal conditions in emergency situations and require invasive patient treatment. In the case of a fatal outcome these measures have to be evaluated at autopsy, regarding indications, correct implementation and possible complications. As well, alongside the more familiar procedures--such as endotracheal intubation, insertion of chest drains, external cardiac massage and cannulation of central and peripheral veins--there are alternative techniques being increasingly applied, that include new tools for the management of hemorrhagic shock, drug delivery and alternative airway management devices. On the one hand, all of these measures are essential for the survival and appropriate treatment of the injured and/or sick patient, but on the other hand they can damage the patient and thus contain a significant risk of both medical and forensic relevance for the patient and the physician. In the following review we provide an overview of established, new and alternative techniques for emergency airway management, administration of drugs and management of hemorrhagic shock. The aim is to facilitate the understanding and autopsy evaluation of current emergency medicine techniques.

  12. Public health medicine: the constant dilemma.

    PubMed

    Eskin, Frada

    2002-03-01

    There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted public health medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective public health medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining public health medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which public health physicians work. Because the majority of public health doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, public health physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of public health medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, public health medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda.

  13. Communication skills training for emergency medicine residents.

    PubMed

    Cinar, Orhan; Ak, Mehmet; Sutcigil, Levent; Congologlu, Emel Dovyap; Canbaz, Hayri; Kilic, Erden; Ozmenler, Kamil Nahit

    2012-02-01

    To determine the effects of a communication skills training program on emergency medicine residents and patient satisfaction. Twenty emergency medicine residents attended a 6-week psychoeducation program that was intended to improve their communication skills. The first three sessions of the psychoeducation program consisted of theoretical education on empathy and communication. Other sessions covered awareness, active communication, and empathic skills on a cognitive behavioral basis using discussion, role play, and homework within an interactive group. The effects of the program were assessed using a communication skills scale, empathy scale, and patient satisfaction survey and were reflected by the reduction in the number of undesirable events between doctors and patients in the emergency department. The mean communication skills score increased from 178.7±19 to 189.2±16 after training (P<0.02). Empathy score also increased from 29.5±9 to 30.7±8, but this difference was not statistically significant (P=0.1). The patient satisfaction survey of 576 patients demonstrated increased scores on confidence in the doctor (88.2±14.6-93.6±10.3; P<0.01); the doctor's respect, kindness, and thoughtfulness (90.3±10.8-94.1±16.5; P<0.01); individualized attention (86.7±9.4-93.9±11.1; P<0.01); devotion of adequate time to listening (88.6±12.3-90.8±14.1; P=0.04); and counseling and information delivery (90.1±11.3-92.2±11.7; P=0.02). The number of undesirable events between doctors and patients decreased 75% from 12 to three. Participation in a communication skills training program was associated with improved communication skills of emergency medicine residents, increased patient satisfaction, and decreased complaints.

  14. Expectations of an emergency medicine clerkship director.

    PubMed

    Rogers, Robert L; Wald, David A; Lin, Michelle; Zun, Leslie S; Christopher, Theodore; Manthey, David E

    2011-05-01

    The clerkship director (CD) serves as a faculty leader within a school of medicine and plays a vital role in the hierarchy of undergraduate medical education. Collectively, CDs across specialties serve a multitude of roles and are responsible for clerkship administration, curricular development, teaching, mentoring, and advising students. The emergency medicine (EM) CD has a vitally important role to play in the future development of medical students. EM CDs should be valued and supported, because they often represent our specialty within the medical school and play a vital role in training the physicians of tomorrow. Opportunities and resources must be made available to CDs to run and maintain a successful EM clerkship, while also balancing their clinical duties and academic endeavors. In addition, EM CDs need support from their respective medical schools and departments to run highly successful medical student rotations. This article was prepared with the objective of establishing the importance of the EM CD, defining the job description of the CD, explaining the importance of adequate release time to perform the role of the CD, and describing the necessary resources and support for the position. With EM becoming an increasingly popular and integral rotation for medical students, it is likely that additional emphasis will be placed on the role of the EM CD. This reference document serves as a template for the job description and expectations of an EM CD. © 2011 by the Society for Academic Emergency Medicine.

  15. [Radiology and emergency medicine: state of the art].

    PubMed

    Danse, E M; Thys, F; Reynaert, M S; Pringot, J; Maldague, B

    1999-02-01

    Emergency medicine has emerged as a specific medical specialty for 30 years. To be efficient, the emergency clinician frequently needs the contribution of radiological examinations. This is the reason why emergency radiology has emerged as a new radiologic subspecialty. The aim of this paper is to review the recent history of emergency medicine and to summarize the present state of the radiological organisation for emergency care in the Western countries.

  16. Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps

    PubMed Central

    Morris, Stephen C.; Schroeder, Erika D.

    2016-01-01

    Introduction International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them. Methods A survey was sent to all U.S. emergency medicine (EM) residencies with publicly available e-mail addresses. The survey documents and examines the training and support that emergency medicine residents are offered for international rotations and the frequency of adverse safety events. Results 72.5% of program director responded that their residents are participating in rotations abroad. However, only 15.4% of programs reported offering training specific to working abroad. The results point to an increased need for specific training and insurance coverage. Conclusion Oversight of international rotations should be improved to guarantee safety and education benefit. PMID:26823933

  17. Recruitment and Retention of Patients into Emergency Medicine Clinical Trials

    PubMed Central

    Cofield, Stacey; Conwit, Robin; Barsan, William; Quinn, James

    2010-01-01

    The emergency medicine and pre-hospital environments are unlike any other clinical environments and require special consideration to allow the successful implementation of clinical trials. This article reviews the specific issues involved in Emergency Medicine Clinical Trials (EMCT), and provides strategies from emergency medicine and non-emergency medicine trials to maximize recruitment and retention. While the evidence supporting some of these strategies is deficient, addressing recruitment and retention issues with specific strategies will help researchers deal with these issues in their funding applications and in turn develop the necessary infrastructure to participate in emergency medicine clinical trials. PMID:21040112

  18. Pediatric training in emergency medicine residency programs.

    PubMed

    Ludwig, S; Fleisher, G; Henretig, F; Ruddy, R

    1982-04-01

    Endorsed emergency medicine (EM) residency programs were surveyed as to the nature and extent of training they provided in pediatric emergency care (PEC). In the surveys returned (82%) there were several important findings. The amount of time in PEC training was generally two months per year of training. This accounted for 16% of training time. However, the volume of pediatric patients was 25% of the overall patient population. There was wide variation in the sites of PEC training. Didactic sessions often did not cover even core topics. The training program directors were equally divided in their satisfaction with this aspect of their programs. Changes were recommended by 80% of the directors. Changes most often suggested were increasing pediatric patient exposure and obtaining PEC specialists as trainers.

  19. Medicine as a Public Calling.

    PubMed

    Bagley, Nicholas

    2015-01-01

    The debate over how to tame private medical spending tends to pit advocates of government-provided insurance--a single-payer scheme--against those who would prefer to harness market forces to hold down costs. When it is mentioned at all, the possibility of regulating the medical industry as a public utility is brusquely dismissed as anathema to the American regulatory tradition. This dismissiveness, however, rests on a failure to appreciate just how deeply the public utility model shaped health law in the twentieth century-- and how it continues to shape health law today. Closer economic regulation of the medical industry may or may not be prudent, but it is by no means incompatible with our governing institutions and political culture. Indeed, the durability of such regulation suggests that the modern embrace of market-based approaches in the medical industry may be more ephemeral than it seems.

  20. Introduction of emergency medicine in China.

    PubMed

    Hou, Xiang-Yu; FitzGerald, Gerard

    2008-08-01

    Over the past 20 years, emergency medicine (EM) in China has been through a period of rapid development. This included the formal establishment of professional association of EM in 1986 and the establishment of ED in all county-level hospitals across the country in the late 1990s. In line with the rapid economic development of China, ED have been equipped with appropriate 'hardware' equipment, but the 'software' part of the ED system remains underdeveloped. Doctors do not usually work exclusively in ED, but on a rotational basis, while also working as specialists in their own departments, such as medicine and surgery. EM in China remains underdeveloped, at least partly, for two main reasons: the current financial status of the health-care system and lack of sufficient numbers of qualified EM specialists. Chinese education and training systems are now beginning to produce high-quality emergency specialists, although there is not yet consistency across all courses. In Australia, the specialty of EM is well developed and, as such, this country is well placed to contribute to the development of ED in China.

  1. Determination of "futility" in emergency medicine.

    PubMed

    Marco, C A; Larkin, G L; Moskop, J C; Derse, A R

    2000-06-01

    The practice of emergency medicine routinely requires rapid decisionmaking regarding various interventions and therapies. Such decisions should be based on the expected risks and benefits to the patient, family, and society. At times, certain interventions and therapies may be considered "futile," or of low expected likelihood of benefit to the patient. Various interpretations of the term "futility" and its practical application to the practice of emergency medicine are explored, as well as background information and potential application of various legal, ethical, and organizational policies regarding the determination of "futility. "Decisions regarding potential benefit of interventions should be based on scientific evidence, societal consensus, and professional standards, not on individual bias regarding quality of life or other subjective matters. Physicians are under no ethical obligation to provide treatments they judge to have no realistic likelihood of benefit to the patient. Decisions to withhold treatment should be made with careful consideration of scientific evidence of likelihood of medical benefit, other benefits (including intangible benefits), potential risks of the proposed intervention, patient preferences, and family wishes. When certain interventions are withheld, special efforts should be made to maintain effective communication, comfort, support, and counseling for the patient, family, and friends.

  2. Cultural Competency Training in Emergency Medicine.

    PubMed

    Mechanic, Oren J; Dubosh, Nicole M; Rosen, Carlo L; Landry, Alden M

    2017-07-01

    The Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients. Physicians must be aware of the cultural diversity of their patient population to appropriately address their medical needs. A better understanding of residency preparedness in cultural competency can lead to better training opportunities and patient care. The objective of this study was to assess residency and faculty exposure to formal cultural competency programs and assess future needs for diversity education. A short survey was sent to all 168 Accreditation Council for Graduate Medical Education program directors through the Council of Emergency Medicine Residency Directors listserv. The survey included drop-down options in addition to open-ended input. Descriptive and bivariate analyses were used to analyze data. The response rate was 43.5% (73/168). Of the 68.5% (50/73) of residency programs that include cultural competency education, 90% (45/50) utilized structured didactics. Of these programs, 86.0% (43/50) included race and ethnicity education, whereas only 40.0% (20/50) included education on patients with limited English proficiency. Resident comfort with cultural competency was unmeasured by most programs (83.6%: 61/73). Of all respondents, 93.2% (68/73) were interested in a universal open-source cultural competency curriculum. The majority of the programs in our sample have formal resident didactics on cultural competency. Some faculty members also receive cultural competency training. There are gaps, however, in types of cultural competency training, and many programs have expressed interest in a universal open-source tool to improve cultural competency for Emergency Medicine residents. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. [Organisation of emergency medicine in France].

    PubMed

    Braun, Françis

    2015-01-01

    The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.

  4. Emerging infectious diseases and travel medicine.

    PubMed

    Ostroff, S M; Kozarsky, P

    1998-03-01

    International movement of individuals, populations, and products is one of the major factors associated with the emergence and reemergence of infectious diseases as the pace of global travel and commerce increases rapidly. Travel can be associated with disease emergence because (1) the disease arises in an area of heavy tourism, (2) tourists may be at heightened risk because of their activities, or (3) because they can act as vectors to transport the agent to new areas. Examples of recently recognized diseases with relationship to travel include HIV, Legionnaire's disease, cyclosporiasis, Vibrio cholerae O139 Bengal, hantavirus, and variant Creutzfeldt-Jacob disease. Reemerging diseases include dengue fever, malaria, cholera, schistosomiasis, leptospirosis, and viral hemorrhagic fevers. In addition, tuberculosis, drug-resistant shigellosis, and cholera have been major concerns in refugee and migrant populations. Because of the unique role of travel in emerging infections, efforts are underway to address this factor by agencies such as the CDC, WHO, the International Society of Travel Medicine, and the travel industry.

  5. Quality criteria for electronic publications in medicine.

    PubMed

    Schulz, S; Auhuber, T; Schrader, U; Klar, R

    1998-01-01

    This paper defines "electronic publications in medicine (EPM)" as computer based training programs, databases, knowledge-based systems, multimedia applications and electronic books running on standard platforms and available by usual distribution channels. A detailed catalogue of quality criteria as a basis for development and evaluation of EPMs is presented. The necessity to raise the quality level of electronic publications is stressed considering aspects of domain knowledge, software engineering, media development, interface design and didactics.

  6. The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs.

    PubMed

    Falvo, Thomas; McKniff, Sueanne; Smolin, Gregory; Vega, David; Amsterdam, James T

    2009-09-01

    Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty. (c) 2009 by the Society for Academic Emergency Medicine.

  7. Regenerative medicine: the emergence of an industry.

    PubMed

    Nerem, Robert M

    2010-12-06

    Over the last quarter of a century there has been an emergence of a tissue engineering industry, one that has now evolved into the broader area of regenerative medicine. There have been 'ups and downs' in this industry; however, it now appears to be on a track that may be described as 'back to the future'. The latest data indicate that for 2007 the private sector activity in the world for this industry is approaching $2.5 billion, with 167 companies/business units and more than 6000 employee full time equivalents. Although small compared with the medical device and also the pharmaceutical industries, these numbers are not insignificant. Thus, there is the indication that this industry, and the related technology, may still achieve its potential and address the needs of millions of patients worldwide, in particular those with needs that currently are unmet.

  8. Diabetic Ketoacidosis: An Emergency Medicine Simulation Scenario.

    PubMed

    Addison, Reuben; Skinner, Tate; Zhou, Felix; Parsons, Michael

    2017-05-29

    Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of undergraduate and postgraduate training. Similarly, effective professional development activities stand to benefit greatly from a more stringent integration of simulation and competency-based approaches. This particularly makes sense when considering the goals of patient safety and achievement of optimal clinical outcomes. The current report describes a simulation training session designed to acquaint emergency medicine residents with the presentation and management of diabetic ketoacidosis (DKA) through the use of simulation.

  9. Regenerative medicine: the emergence of an industry

    PubMed Central

    Nerem, Robert M.

    2010-01-01

    Over the last quarter of a century there has been an emergence of a tissue engineering industry, one that has now evolved into the broader area of regenerative medicine. There have been ‘ups and downs’ in this industry; however, it now appears to be on a track that may be described as ‘back to the future’. The latest data indicate that for 2007 the private sector activity in the world for this industry is approaching $2.5 billion, with 167 companies/business units and more than 6000 employee full time equivalents. Although small compared with the medical device and also the pharmaceutical industries, these numbers are not insignificant. Thus, there is the indication that this industry, and the related technology, may still achieve its potential and address the needs of millions of patients worldwide, in particular those with needs that currently are unmet. PMID:20843840

  10. The use of automated external defibrillators and public access defibrillators in the mountains: official guidelines of the international commission for mountain emergency medicine ICAR-MEDCOM.

    PubMed

    Elsensohn, Fidel; Agazzi, Giancelso; Syme, David; Swangard, Michael; Facchetti, Gianluca; Brugger, Hermann

    2006-01-01

    In this article we propose guidelines for rational use of automated external defibrillators and public access defibrillators in the mountains. In cases of ventricular fibrillation and pulseless ventricular tachycardia, early defibrillation is the most effective therapy. Easy access to mountainous areas permits visitation by persons with high risks for sudden cardiac death, and medical trials show the benefit of exercising in moderate altitude. The introduction of public access defibrillators in popular areas in the mountains may lead to a reduction of fatal outcome of cardiac arrest. Public access defibrillators should be placed with priority in popular ski areas, in busy mountain huts and restaurants, at mass-participation events, and in remote but often-visited locations that do not have medical coverage. Automated external defibrillators should be available to first-responder groups and mountain-rescue teams. It is important that people know how to perform cardiopulmonary resuscitation and how to use public access defibrillators and automated external defibrillators.

  11. Pharmacogenomics and public health: implementing 'populationalized' medicine.

    PubMed

    Mette, Lindsey; Mitropoulos, Konstantinos; Vozikis, Athanassios; Patrinos, George P

    2012-05-01

    Pharmacogenomics are frequently considered in personalized medicine to maximize therapeutic benefits and minimize adverse drug reactions. However, there is a movement towards applying this technology to populations, which may produce the same benefits, while saving already scarce health resources. We conducted a narrative literature review to examine how pharmacogenomics and public health can constructively intersect, particularly in resource-poor settings. We identified 27 articles addressing the research question. Real and theoretical connections between public health and pharmacogenomics were presented in the areas of disease, drugs and public policy. Suggested points for consideration, such as educational efforts and cultural acceptability, were also provided. Including pharmacogenomics in public health can result in both health-related and economic benefits. Including pharmacogenomics in public health holds promise but deserves extensive consideration. To fully realize the benefits of this technology, support is needed from private, public and governmental sectors in order to ensure the appropriateness within a society.

  12. Blog and Podcast Watch: Pediatric Emergency Medicine.

    PubMed

    Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

    2016-09-01

    By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. The Approved Instructional Resources - Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An "Honorable Mention" label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians.

  13. Blog and Podcast Watch: Pediatric Emergency Medicine

    PubMed Central

    Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

    2016-01-01

    Introduction By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. Methods The Approved Instructional Resources – Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. PMID:27625713

  14. [Crises of public health, medicine, society?].

    PubMed

    Thilly, C H

    1995-01-01

    Public health is in crisis. Apart from temporary factors, this crisis could have also its origin in theoretical and conceptual insufficiencies relative to the definition of this scientific domain. Organisational and institutional conditions needed for the strengthening of public health are discussed in relation with the localization of its production sites, taking into account the needed synthesis or consensus to reach and in view of the larger and valuable intellectual traditions to which it belongs. The crisis of public health is only part of a crisis of medicine and of our modern societies.

  15. Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

    PubMed

    Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

    2008-08-01

    The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

  16. Assessment of emergency medicine residents: a systematic review

    PubMed Central

    Colmers-Gray, Isabelle N.; Walsh, Kieran; Chan, Teresa M.

    2017-01-01

    Background Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. Methods We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 – June 2014. MeSH terms included “assessment,” “residency,” and “emergency medicine.” We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident. Two reviewers screened abstracts, reviewed full text studies, and abstracted data. Reporting of assessment-related costs was a secondary outcome. Results The search returned 879 articles; 137 articles were full-text reviewed; 73 met inclusion criteria. Half of the studies (54.8%) were pilot projects and one-quarter (26.0%) described fully implemented assessment tools/programs. Assessment tools (n=111) comprised 12 categories, most commonly: simulation-based assessments (28.8%), written exams (28.8%), and direct observation (26.0%). Median assessment frequency (n=39 studies) was twice per month/rotation (range: daily to once in residency). No studies thoroughly reported costs. Conclusion EM resident assessment commonly uses simulation or direct observation, done once-per-rotation. Implemented assessment systems and assessment-associated costs are poorly reported. Moving forward, routine publication will facilitate transitioning to competency-based medical education. PMID:28344722

  17. Law, liability, and public health emergencies.

    PubMed

    Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D

    2009-06-01

    According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

  18. Critical drug shortages: implications for emergency medicine.

    PubMed

    Mazer-Amirshahi, Maryann; Pourmand, Ali; Singer, Steven; Pines, Jesse M; van den Anker, John

    2014-06-01

    information during resuscitations. This review focuses on the etiology of drug shortages, their effect on the ED, and potential solutions and mitigation strategies. © 2014 by the Society for Academic Emergency Medicine.

  19. Annals of Emergency Medicine Journal Club. Global Emergency Medicine Journal Club: Social media responses to the November 2013 Annals of Emergency Medicine Journal Club.

    PubMed

    Radecki, Ryan P; Rezaie, Salim R; Lin, Michelle

    2014-04-01

    The Annals November 2013 Journal Club issue marked one of the first collaborations with Academic Life in Emergency Medicine, a medical education blog, in an effort to promote a worldwide, transparent, online effort to perform critical appraisals of journal articles. The Global Emergency Medicine Journal Club was hosted on the blog for 1 week during November 18 to 24, 2013, with comments moderated on the blog and on Twitter. This summary article compiles the discussion and insights.

  20. Publishing Trends in the Field of Pediatric Emergency Medicine From 2004 to 2013.

    PubMed

    Rixe, Nancy S; Rixe, Jeffrey; Glick, Joshua; Lehman, Erik; Olympia, Robert P

    2016-12-01

    To identify publishing trends within the field of pediatric emergency medicine between 2004 and 2013. We conducted a MEDLINE search of pediatric emergency medicine articles, filtered by clinical trial, published between 2004 and 2013 in ten journals from the fields of pediatrics, emergency medicine, general medicine, and pediatric emergency medicine. Each article was classified by journal type, study design, results (positive or negative/equivocal), age/type of subjects, and major topic (based on the objective of the study). Articles were stratified by publication period (2004-2008 or 2009-2013) to analyze trends. A total of 464 articles were analyzed. The majority of articles were described as randomized-controlled trials (47%) with negative/equivocal findings (70%). The most common major topics were pain management, asthma, sedation, bronchiolitis, resuscitation, simulation, and ultrasound. Over time, the percentage of articles published in pediatrics and pediatric emergency medicine journals increased (P = 0.0499) and the percentage for all study designs increased except for randomized controlled trials (P = 0.0089). There were no differences between the 2 publication periods when stratified by results, age/type of subjects, and major topic. By identifying these trends, we hope to encourage researchers to perform studies in the field of pediatric emergency medicine where deficiencies lie and to guide pediatric health care professionals to where published, evidence-based studies can be found in the medical literature.

  1. Rubric Evaluation of Pediatric Emergency Medicine Fellows

    PubMed Central

    Hsu, Deborah C.; Macias, Charles G.

    2010-01-01

    Objectives To develop and validate a rubric assessment instrument for use by pediatric emergency medicine (PEM) faculty to evaluate PEM fellows and for fellows to use to self-assess. Methods This is a prospective study at a PEM fellowship program. The assessment instrument was developed through a multistep process: (1) development of rubric format items, scaled on the modified Dreyfus model proficiency levels, corresponding to the 6 Accreditation Council for Graduate Medical Education core competencies; (2) determination of content and construct validity of the items through structured input and item refinement by subject matter experts and focus group review; (3) collection of data using a 61-item form; (4) evaluation of psychometrics; (5) selection of items for use in the final instrument. Results A total of 261 evaluations were collected from 2006 to 2007; exploratory factor analysis yielded 5 factors with Eigenvalues >1.0; each contained ≥4 items, with factor loadings >0.4 corresponding with the following competencies: (1) medical knowledge and practice-based learning and improvement, (2) patient care and systems-based practice, (3) interpersonal skills, (4) communication skills, and (5) professionalism. Cronbach α for the final 53-item instrument was 0.989. There was also significant responsiveness of the tool to the year of training. Conclusion A substantively and statistically validated rubric evaluation of PEM fellows is a reliable tool for formative and summative evaluation. PMID:22132272

  2. Core content for wilderness medicine fellowship training of emergency medicine graduates.

    PubMed

    Lipman, Grant S; Weichenthal, Lori; Stuart Harris, N; McIntosh, Scott E; Cushing, Tracy; Caudell, Michael J; Macias, Darryl J; Weiss, Eric A; Lemery, Jay; Ellis, Mark A; Spano, Susanne; McDevitt, Marion; Tedeschi, Christopher; Dow, Jennifer; Mazzorana, Vicki; McGinnis, Henderson; Gardner, Angela F; Auerbach, Paul S

    2014-02-01

    Wilderness medicine is the practice of resource-limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)-based wilderness medicine fellowships. This paper describes the process and results of what became a 4-year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1-year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship.

  3. Future directions in sex- and Gender-specific Emergency Medicine.

    PubMed

    Greenberg, Marna R; Safdar, Basmah; Choo, Esther K; McGregor, Alyson J; Becker, Lance B; Cone, David C

    2014-12-01

    The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes" convened a diverse group of stakeholders to target gaps in emergency medicine (EM) sex- and gender-specific research and identify research priorities. At the close of the conference, the executive committee sought feedback from group leaders and conference attendees about the next critical steps in EM sex- and gender-specific research, goals for their own future research, and anticipated barriers in pursuing this research. This article summarizes this feedback on the future directions in sex- and gender-specific research in emergency care and strategies to overcome barriers. © 2014 by the Society for Academic Emergency Medicine.

  4. Animal laboratories for procedural education of emergency medicine residents.

    PubMed

    Custalow, Catherine B; Williams-Murphy, Monica

    2004-04-01

    Many Emergency Medicine residencies incorporate animal laboratories into their training for procedural education because clinical opportunities to practice some emergency technical procedures are limited. To determine the proportion of Emergency Medicine residency programs utilizing animal laboratories, their characteristics, and the major impediments to providing animal laboratories, a cross-sectional descriptive survey of Emergency Medicine residency directors was conducted. Surveys were returned by 109/123 (89%) program directors. Ninety-four (87%) programs provide live animal laboratories for procedural training, an increase from previous studies. Although only 28% of directors knew the cost of the laboratories, this was the most commonly listed impediment (66%) to providing them. In conclusion, the use of animal laboratories for procedural training in Emergency Medicine residencies has increased in recent years. Cost is reported to be the most significant impediment to providing animal laboratories. The majority of program directors do not know the actual expense of providing animal laboratories.

  5. Radiological errors in the Canadian Journal of Emergency Medicine.

    PubMed

    McEachern, James D; Leswick, David A; Stoneham, Grant W; Mohr, Karen L; Stempien, James E

    2014-09-01

    To systematically evaluate the accuracy of text descriptions and labeling of radiologic images published in the Canadian Journal of Emergency Medicine (CJEM). Error detection by radiologists and emergency physicians and the clinical significance and educational value of these errors were assessed. Errors were also correlated with radiologist involvement in publication and imaging modality. Thirty-three issues of CJEM were examined from January 2003 to May 2008. Electronic copies of all radiologic images published were obtained with their caption and description from the text. Identifying information was removed to present images in an anonymous fashion. Images were presented to two radiologists who, working in consensus, critically appraised each image and accompanying text. Images were then presented to two emergency department physicians who, working in consensus, critically appraised each image and accompanying text. All images with errors detected by either radiology or emergency physicians were then discussed to determine if errors would have affected clinical management or educational value. The emergency physicians also identified "underlabeled" images where it was felt that further labeling would enhance their educational value. Forty-five articles with 82 images were obtained. At least one error was observed in 18 (40%) articles and 20 (24%) images. Two errors were present in three images, resulting in 23 errors. Of the 23 errors, 17 were image description errors and 6 were labeling errors. Five errors were detected by both radiology and emergency physicians, whereas 15 were detected only by radiologists and 3 were detected only by emergency physicians. Of these errors, 12 (52%) were rated as potentially affecting both clinical management and educational value, 5 (22%) as only affecting educational value, and 6 (26%) as nonsignificant. Radiologists were involved in six articles, including 12 images that contained no errors. There was no official

  6. Reuniting public health and medicine: the University of New Mexico School of Medicine Public Health Certificate.

    PubMed

    Geppert, Cynthia M A; Arndell, Cynthia L; Clithero, Amy; Dow-Velarde, Lily A; Eldredge, Jonathan D; Eldredge, Jonathan P; Kalishman, Summers; Kaufman, Arthur; McGrew, Martha C; Snyder, Tiffany M; Solan, Brian G; Timm, Craig T; Tollestrup, Kristine; Wagner, Lana K; Wiese, William H; Wiggins, Charles L; Cosgrove, Ellen M

    2011-10-01

    The University of New Mexico School of Medicine (UNMSOM) sought to train medical students in public health concepts, knowledge, and skills as a means of improving the health of communities statewide. Faculty members from every UNMSOM department collaborated to create and integrate a public health focus into all years of the medical school curriculum. They identified key competencies and developed new courses that would synchronize students' learning public health subjects with the mainstream medical school content. New courses include: Health Equity: Principles of Public Health; Epidemiology and Biostatistics; Evidence-Based Practice; Community-Based Service Learning; and Ethics in Public Health. Students experiencing the new courses, first in pilot and then final forms, gave high quantitative ratings to all courses. Some students' qualitative comments suggest that the Public Health Certificate has had a profound transformative effect. Instituting the integrated Public Health Certificate at UNMSOM places it among the first medical schools to require all its medical students to complete medical school with public health training. The new UNMSOM Public Health Certificate courses reunite medicine and public health in a unified curriculum.

  7. [The Sino-French emergency and disaster medicine training center].

    PubMed

    Pourriat, Jean-Louis; Dahan, Benjamin; Lapandry, Claude

    2012-01-01

    French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal). This collaboration has had both pedagogical and diplomatic benefits.

  8. Emerging issues in public health genomics

    PubMed Central

    Roberts, J. Scott

    2014-01-01

    This review highlights emerging areas of interest in public health genomics. First, recent advances in newborn screening (NBS) are described, with a focus on practice and policy implications of current and future efforts to expand NBS programs (e.g., via next-generation sequencing). Next, research findings from the rapidly progressing field of epigenetics and epigenomics are detailed, highlighting ways in which our emerging understanding in these areas could guide future intervention and research efforts in public health. We close by considering various ethical, legal and social issues posed by recent developments in public health genomics; these include policies to regulate access to personal genomic information; the need to enhance genetic literacy in both health professionals and the public; and challenges in ensuring that the benefits (and burdens) from genomic discoveries and applications are equitably distributed. Needs for future genomics research that integrates across basic and social sciences are also noted. PMID:25184533

  9. Emerging issues in public health genomics.

    PubMed

    Roberts, J Scott; Dolinoy, Dana; Tarini, Beth

    2014-01-01

    This review highlights emerging areas of interest in public health genomics. First, we describe recent advances in newborn screening (NBS), with a focus on the practice and policy implications of current and future efforts to expand NBS programs (e.g., via next-generation sequencing). Next, we detail research findings from the rapidly progressing field of epigenetics and epigenomics, highlighting ways in which our emerging understanding in these areas could guide future intervention and research efforts in public health. We close by considering various ethical, legal, and social issues posed by recent developments in public health genomics; these include policies to regulate access to personal genomic information, the need to enhance genetic literacy in both health professionals and the public, and challenges in ensuring that the benefits (and burdens) of genomic discoveries and applications are equitably distributed. We also note needs for future genomic research that integrates across basic and social sciences.

  10. Emergency Medicine Resident Perceptions of Medical Professionalism

    PubMed Central

    Jauregui, Joshua; Gatewood, Medley O.; Ilgen, Jonathan S.; Schaninger, Caitlin; Strote, Jared

    2016-01-01

    Introduction Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05). Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05). Conclusion Residents perceive differences in the relative

  11. Progression of emergency medicine resident productivity.

    PubMed

    Brennan, Daniel F; Silvestri, Salvatore; Sun, Joanne Y; Papa, Linda

    2007-09-01

    To evaluate the progression in productivity of emergency medicine (EM) residents by postgraduate year, as measured by hourly work in relative value units (RVUs). This retrospective study was conducted at an Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency with a postgraduate year (PGY) 1-2-3 configuration. A query of an electronic billing database composed of more than 230,000 visits from academic years July 2003 to December 2006, representing at least four classes at each PGY level, was conducted. The main outcome was change in productivity in RVUs generated per hour, compared by resident PGY level. This measure encompasses not only volume of patients seen but also patient acuity in terms of evaluation and management services and procedures provided and supported by documentation adequate for coding. Descriptive statistics and Tukey's test were used for data analysis. Over the three-year study period, 70 EM residents were assessed at various levels of training. Productivity, as measured by mean RVUs generated per hour, was 2.51 (95% confidence interval [CI] = 2.20 to 2.82) for PGY-1 residents, 3.51 (95% CI = 3.12 to 3.90) for PGY-2 residents, and 3.61 (95% CI = 3.41 to 3.80) for PGY-3 residents (p < 0.001). Patient acuity (RVUs generated per patient) increased 5%-8% with each PGY progression: 3.05 (95% CI = 2.96 to 3.13) for PGY-1, 3.20 (95% CI = 3.09 to 3.31) for PGY-2, and 3.46 (95% CI = 3.42 to 3.50) for PGY-3 (p < 0.001). There was a statistically significant increase in productivity (p < 0.001) and acuity (p = 0.03) from PGY-1 to PGY-2, with acuity also increasing between PGY-2 and PGY-3 (p < 0.001). Hourly work productivity and acuity increased with experience within this ACGME-accredited EM residency. The progression in workload and acuity by PGY is measurable and commensurate with the graduated level of responsibility desired in an EM program.

  12. Back to basics: emergency medicine in dentistry.

    PubMed

    Malamed, S F

    1997-04-01

    It is important that all members of the dental office staff be trained to promptly recognize and efficiently manage emergency situations. This paper discusses how to prepare a dental office and staff for emergencies. It also describes several emergencies that may occur in dental offices and discusses methods of handling them.

  13. Forensic emergency medicine: old wine in new barrels.

    PubMed

    De Leeuw, Marc; Jacobs, Werner

    2010-08-01

    Emergency and forensic physicians may find themselves sometimes on the same medical battleground but with different primary aims and hence often ignore or do not recognize each other's needs. The emergency physician interacts with law enforcement agencies with greater frequency than any other hospital physician and hence needs expertise with legal issues. Awareness of the forensic relevance of certain medical observations by emergency physicians, knowledge of emergency medicine methodology and techniques and of resuscitation-related injuries by forensic physicians may lead to a higher standard in both forensic and emergency medicine, a better serving of the criminal justice system, and most importantly safeguarding the rights of victims of criminal assault. It is this achievable mutual symbiosis that we would like to refer to as the concept of 'forensic emergency medicine'.

  14. Enhancing crisis leadership in public health emergencies.

    PubMed

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  15. Review article: Crisis resource management in emergency medicine.

    PubMed

    Carne, Belinda; Kennedy, Marcus; Gray, Tim

    2012-02-01

    Effective team management is a core element of expert practice in emergency medicine. Thus far, training in emergency medicine has focussed predominantly on proficiency in medical and technical skills, with emergency physicians acquiring these 'non-technical' skills in an ad hoc manner or by trial and error with varying levels of success. This paper describes a set of behaviours that, when practised in conjunction with medical and technical expertise, can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of an ED. Teaching and practice of these behaviours is now a core element of training and skills maintenance in other high-risk areas, such as aviation, and is becoming part of the routine training for anaesthetists. They address areas, such as communication, leadership, knowledge of environment, anticipation and planning, obtaining timely assistance, attention allocation and workload distribution. We outline the application of these behaviours in the speciality of emergency medicine, and suggest that the teaching and practice of crisis resource management principles should become part of the curriculum for training and credentialing of emergency medicine specialists. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. Choosing Wisely in Emergency Medicine: A National Survey of Emergency Medicine Academic Chairs and Division Chiefs.

    PubMed

    Maughan, Brandon C; Baren, Jill M; Shea, Judy A; Merchant, Raina M

    2015-12-01

    The Choosing Wisely campaign was launched in 2011 to promote stewardship of medical resources by encouraging patients and physicians to speak with each other regarding the appropriateness of common tests and procedures. Medical societies including the American College of Emergency Physicians (ACEP) have developed lists of potentially low-value practices for their members to address with patients. No research has described the awareness or attitudes of emergency physicians (EPs) regarding the Choosing Wisely campaign. The study objective was to assess these beliefs among leaders of academic departments of emergency medicine (EM). This was a Web-based survey of emergency department (ED) chairs and division chiefs at institutions with allopathic EM residency programs. The survey examined awareness of Choosing Wisely, anticipated effects of the program, and discussions of Choosing Wisely with patients and professional colleagues. Participants also identified factors they associated with the use of potentially low-value services in the ED. Questions and answer scales were refined using iterative pilot testing with EPs and health services researchers. Seventy-eight percent (105/134) of invited participants responded to the survey. Eighty percent of respondents were aware of Choosing Wisely. A majority of participants anticipate the program will decrease costs of care (72% of respondents) and use of ED diagnostic imaging (69%) but will have no effect on EP salaries (94%) or medical-legal risks (65%). Only 45% of chairs have ever addressed Choosing Wisely with patients, in contrast to 88 and 82% who have discussed it with faculty and residents, respectively. Consultant-requested tests were identified by 97% of residents as a potential contributor to low-value services in the ED. A substantial majority of academic EM leaders in our study were aware of Choosing Wisely, but only slightly more than half could recall any ACEP recommendations for the program. Respondents

  17. Report on residency training information (2011-2012), American Board of Emergency Medicine.

    PubMed

    Smith-Coggins, Rebecca; Carius, Michael L; Collier, Robert E; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Korte, Robert C

    2012-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency training programs and the residents in those programs. We present the 2012 annual report on the status of US emergency medicine training programs.

  18. American Board of Emergency Medicine report on residency training information (2014-2015).

    PubMed

    Smith-Coggins, Rebecca; Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Heller, Barry N; Kowalenko, Terry; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C; Joldersma, Kevin B

    2015-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2015 annual report on the status of US emergency medicine training programs.

  19. American Board of Emergency Medicine Report on Residency Training Information (2015-2016).

    PubMed

    Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Gausche-Hill, Marianne; Goyal, Deepi G; Kowalenko, Terry; Muelleman, Robert L; Wahl, Robert P; Joldersma, Kevin B

    2016-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2016 annual report on the status of US emergency medicine training programs.

  20. Risk communication for public health emergencies.

    PubMed

    Glik, Deborah C

    2007-01-01

    This review defines crisis risk communication, traces its origins to a number of applied fields, and then shows how basic principles have become incorporated into emergency preparedness and risk communication for public health. Literature from four different disciplines that inform crisis risk communications are reviewed. These are (a) environmental risk communication, (b) disaster management, (c) health promotion and communication, and (d) media and communication studies. Current curricula and training materials are briefly reviewed. Although this literature review suggests much progress has been made to incorporate and disseminate crisis risk communication principles into public health practice, and case studies suggest that public health workers have gained skills and experience, this emerging field still lacks in-depth evaluation of the effectiveness of event-specific crisis risk communication efforts.

  1. 1 CFR 17.3 - Criteria for emergency publication.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Criteria for emergency publication. 17.3..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the...

  2. 1 CFR 17.3 - Criteria for emergency publication.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Criteria for emergency publication. 17.3..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the...

  3. 1 CFR 17.3 - Criteria for emergency publication.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the...

  4. 1 CFR 17.3 - Criteria for emergency publication.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the...

  5. Chemical warfare agents: emergency medical and emergency public health issues.

    PubMed

    Brennan, R J; Waeckerle, J F; Sharp, T W; Lillibridge, S R

    1999-08-01

    The threat of exposure to chemical warfare agents has traditionally been considered a military issue. Several recent events have demonstrated that civilians may also be exposed to these agents. The intentional or unintentional release of a chemical warfare agent in a civilian community has the potential to create thousands of casualties, thereby overwhelming local health and medical resources. The resources of US communities to respond to chemical incidents have been designed primarily for industrial agents, but must be expanded and developed regarding incident management, agent detection, protection of emergency personnel, and clinical care. We present an overview of the risk that chemical warfare agents presently pose to civilian populations and a discussion of the emergency medical and emergency public health issues related to preparedness and response.

  6. New diploma in emergency medicine in France: the students' perspective.

    PubMed

    Dehours, Emilie; Vallé, Baptiste; Concina, François; Bounes, Vincent; Ducassé, Jean-Louis; Lauque, Dominique

    2013-04-01

    French emergency medicine (EM) has undergone rapid changes with the establishment of a diploma in emergency medicine (DES). We aimed to question medicine students on their knowledge of and apprehensions regarding this new DES. We conducted an email cross-sectional survey among second-cycle medical students before their choice of resident speciality. This included a demographic study and an evaluation of the willingness to choose emergency specialization. Two thousand and three fully completed questionnaires were analysed. Twenty-six per cent of the students (n=524) planned to choose emergency specialization and 54% of the students (n=1084) knew that emergency specialization would be proposed as a full speciality. Seventy-six per cent of students considered it tough to practice as an entire career. This study clearly shows that EM represents an attractive option for medical students. The establishment of DES represents a major step in the improvement of EM.

  7. [Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures].

    PubMed

    Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus

    2015-06-01

    Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.

  8. Partnerships to provide care and medicine for chronic diseases: a model for emerging markets.

    PubMed

    Goroff, Michael; Reich, Michael R

    2010-12-01

    The challenge of expanding access to treatment and medicine for chronic diseases in emerging markets is both a public health imperative and a commercial opportunity. Cross-sector partnerships-involving a pharmaceutical manufacturer; a local health care provider; and other private, public, and nonprofit entities-could address this challenge. Such partnerships would provide integrated, comprehensive care and medicines for a specific chronic disease, with medicines directly supplied to the partnership at preferential prices by the manufacturer. The model discussed here requires additional specification, using real numbers and specific contexts, to assess its feasibility. Still, we believe that this model has the potential for public health and private business to cooperate in addressing the rising problem of chronic diseases in emerging markets.

  9. An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine

    PubMed Central

    Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

    2017-01-01

    Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. PMID:28473529

  10. International Federation for Emergency Medicine point of care ultrasound curriculum.

    PubMed

    Atkinson, Paul; Bowra, Justin; Lambert, Mike; Lamprecht, Hein; Noble, Vicki; Jarman, Bob

    2015-03-01

    To meet a critical and growing need for a standardized approach to emergency point of care ultrasound (PoCUS) worldwide, emergency physicians must be trained to deliver and teach this skill in an accepted and reliable format. Currently, there is no globally recognized, standard PoCUS curriculum that defines the accepted applications, as well as standards for training and practice of PoCUS by specialists and trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine (IFEM) convened a sub-committee of international experts in PoCUS to outline a curriculum for training of specialists in emergency PoCUS. This curriculum document represents the consensus of recommendations by this sub-committee. The curriculum is designed to provide a framework for PoCUS education in emergency medicine. The focus is on the processes required to select core and enhanced applications, as well as the key elements required for the delivery of PoCUS training from introduction through to continuing professional development and skill maintenance. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance PoCUS education in emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems but in particular for developing nations or for nations seeking to develop PoCUS training programs within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught, reflecting the existing educational environment, resources and goals of educational programs.

  11. Accident and emergency medicine--making waves on the Internet.

    PubMed Central

    Ryan, J M; Baldock, C; Lawson-Smith, R

    1997-01-01

    The internet is a communications and information tool which has recently entered the world of accident and emergency (A&E) medicine. It is a worldwide instrument facilitating the dissemination of ideas and clinical information in the specialty. It is being embraced by all disciplines involved in A&E medicine. Part I introduces the internet to those in A&E medicine unfamiliar with this technology. It describes the varied resources of the internet in A&E medicine and speculates on its future role. Part II supplies the reader with the necessary information to get on-line and explains some of the more technical aspects of the internet. PMID:9413781

  12. Public health and disability: emerging opportunities.

    PubMed

    Lollar, Donald J

    2002-01-01

    The public health community has traditionally paid little attention to the health needs of people with disabilities. Recent activities, however, on the part of federal and international organizations mark a shift toward engaging the health concerns of this large and growing population. First, the World Health Organization published the International Classification of Functioning, Disability, and Health (ICF), a companion to the International Classification of Diseases. The ICF describes both a conceptual framework and a classification system, providing the foundation for public health science and policy. Second, a vision for the future of public health and disability is outlined in Healthy People 2010 that, for the first time, includes people with disabilities as a targeted population. The article briefly describes activities and emerging opportunities for a public health focus on people with disabilities with the ICF as a foundation and Healthy People 2010 as a vision. Public health has traditionally responded to emerging needs; people with disabilities are a group whose health needs should be targeted.

  13. [Use of telematics in emergency medicine].

    PubMed

    Masić, I; Macić, A; Banjanović, B; Knezević, Z; Masić, Z; Toromanović, S; Pandza, H; Pasić, E

    2000-01-01

    Health telematics is a composite term for health-related activities, services and systems carried out over a distance by means of information and communications technololgies, for the purposes of global health promotion, disease control and health care, as well as education, management, and research for health. The concept of health telematics encompasses the following functional areas:--tele-education;--telemedicine;--telematics for health research;--telematics for health services management. Communications technologies are rapidly revolutionizing health care. For example, electronic communications support diagnosis and treatment of disease. TeleMedicine is an umbrella term for growing disciplines such as TeleRadiology, TelePathology, TeleCardiology, TelePsychiatry and TeleEducation. TeleMedicine is a component of TeleHealth, which includes the use of telecommunications technology and services for the surveillance and control of diseases and education. In this article authors describes the role of telemedicine and telematics in medical education and medical praxis.

  14. The light of emergency medicine: Vietnam-the next chapter in the global history of emergency medicine?

    PubMed

    Suter, Robert E

    2011-04-01

    The following is the keynote address to the First Emergency Medicine Conference in Vietnam, held in the historic city of Hue, March 22-26, 2010. This presentation reviewed the global history of emergency medicine (EM) and presented the need for the establishment of EM residency programs in Vietnam in a culturally sensitive manner. Immediately following this presentation, the Deputy Minister of Health for Vietnam announced recognition of EM as a specialty in Vietnam, and the establishment of EM residency programs, with the first starting October 1, 2010, in association with the Hue College of Medicine.

  15. [Preventive medicine in emergency centres: an opportunity of partnership for emergency physicians and primary care physicians].

    PubMed

    Guessous, I; Cornuz, J; Hugli, O W; Yersin, B

    2006-08-09

    Whereas preventive interventions for primary care physicians are now well established, the preventive interventions in emergency departments have been only partially and recently evaluated. Emergency departments probably represent however an opportunity for preventive medicine. Indeed, the population, sometimes vulnerable, consulting emergency departments, frequently presents risks factors and risks behaviours. Moreover, the concept of "teachable moment" and the studies recently performed seem to confirm this hypothesis. This article review the currently preventive interventions recommended in emergency departments and discuss the rationale to implement preventive medicine in emergency departments and the limits of this process.

  16. A Model Longitudinal Observation Medicine Curriculum for an Emergency Medicine Residency.

    PubMed

    Wheatley, Matthew; Baugh, Christopher; Osborne, Anwar; Clark, Carol; Shayne, Philip; Ross, Michael

    2016-04-01

    The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians. Presented here is a model observation medicine longitudinal training curriculum, which can be integrated into an emergency medicine (EM) residency. It was developed by a consensus of content experts representing the observation medicine interest group and observation medicine section, respectively, from EM's two major specialty societies: the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP). The curriculum consists of didactic, clinical, and self-directed elements. It is longitudinal, with learning objectives for each year of training, focusing initially on the basic principles of observation medicine and appropriate observation patient selection; moving to the management of various observation appropriate conditions; and then incorporating further concepts of OU management, billing, and administration. This curriculum is flexible and designed to be used in both academic and community EM training programs within the United States. Additionally, scholarly opportunities, such as elective rotations and fellowship training, are explored.

  17. Emergency medicine and the airline passenger

    NASA Technical Reports Server (NTRS)

    Mohler, S. R.; Nicogossian, A.; Margulies, R. A.

    1980-01-01

    Problems related to immediate medical care in case of in-flight emergencies are discussed with reference to such critical types of medical emergencies as obstructed airway, cardiac dysfunction, trauma, hemorrhage, hypoxia, and pain. It is shown that training flight attendants to deal with in-flight medical emergencies and to use first-aid support equipment and essential and useful drugs may later help with stabilization of a victim and allow continuing the flight to the scheduled destination without the need for a diverted landing. Among the steps suggested in order to upgrade inflight welfare and safety of passengers are the development of an advisory circular by the FAA covering standardized training for flight attendants, regulatory action requiring upgrading of the present rudimentary first-aid kit, and the enactment of Good Samaritan legislation by the U.S. Government.

  18. Emergency Medicine and the Underage Athlete

    PubMed Central

    Martin, David E.

    1994-01-01

    Most high school and some collegiate athletes are legal minors. In civil matters, the law treats minors (usually individuals under the age of 18 years) uniquely. Limitations exist on a minor's ability to enter into contracts, make determinations regarding medical care, and bear responsibility for personal actions. Medical professionals are often unclear on matters relating to the provision of medical care to minors. The purpose of this discourse is to present selected legal issues in the context of two fictional case studies. Case 1 presents issues regarding the definition of emergency medical conditions and the related emergency medical doctrine. Case 2 provides an example of an acute medical concern which fails to fall under emergency medical classification but rather provides a context for discussing the mature minor doctrine. Both cases are analyzed in light of these doctrines in addition to other pertinent legal considerations. PMID:16558280

  19. Emergency medicine and the airline passenger

    NASA Technical Reports Server (NTRS)

    Mohler, S. R.; Nicogossian, A.; Margulies, R. A.

    1980-01-01

    Problems related to immediate medical care in case of in-flight emergencies are discussed with reference to such critical types of medical emergencies as obstructed airway, cardiac dysfunction, trauma, hemorrhage, hypoxia, and pain. It is shown that training flight attendants to deal with in-flight medical emergencies and to use first-aid support equipment and essential and useful drugs may later help with stabilization of a victim and allow continuing the flight to the scheduled destination without the need for a diverted landing. Among the steps suggested in order to upgrade inflight welfare and safety of passengers are the development of an advisory circular by the FAA covering standardized training for flight attendants, regulatory action requiring upgrading of the present rudimentary first-aid kit, and the enactment of Good Samaritan legislation by the U.S. Government.

  20. [Future of emergency medicine in Germany 2.0].

    PubMed

    Gries, A; Bernhard, M; Helm, M; Brokmann, J; Gräsner, J-T

    2017-05-01

    In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment. Now after 15 years, the authors have critically assessed the development postulated in 2003 and reevaluated it. Which aspects could be developed further and become firmly established, what is still open and which questions in preclinical and clinical emergency treatment of the population will occupy us in the coming 15 years? With a critical eye to the past, the present contribution aims to capture the essential and new topics and open questions and provide a fresh perspective for the future of emergency medicine. Regulation at the state level or even lower levels of government often stand in contrast to more sweeping and economically effective approaches at the federal level. Prehospital emergency medicine in Germany is on the whole well-positioned with respect to facilities and personnel; however, as far as the economic situation and the utilization of available systems are concerned, there is still substantial room for improvement.

  1. Emergency medicine directors' perceptions on professionalism: a Council of Emergency Medicine Residency Directors survey.

    PubMed

    Sullivan, Christine; Murano, Tiffany; Comes, Jim; Smith, Jessica L; Katz, Eric D

    2011-10-01

    The Accreditation Council for Graduate Medical Education requires residency training programs to teach and assess professionalism in residents; however, programs may struggle to successfully remediate residents not meeting professionalism standards. To assist programs with this complex issue, a Professionalism Remediation Task Force was formed by the Council of Emergency Medicine Residency Directors (CORD-EM), which surveyed program directors (PDs) concerning their experiences. The purpose of this study is to report survey results regarding the identification and rating of unprofessional behaviors and challenges in the evaluation and remediation of professionalism. In June 2010, the task force sent an anonymous survey via the CORD-EM listserv to PDs with active EM programs. Fifty percent (77/154) of eligible PDs responded to the survey. Most PDs rated the unprofessional behaviors of interpersonal/communication conflicts, lack of responsibility during patient care, lack of respect of coworkers, and reports of impairment as "critical"; repeated tardiness, incomplete work, poor ability to accept feedback, poor attitude, and repetitive unresponsiveness to aid colleagues were rated as "very serious"; frequent missed deadlines were "serious"; and repetitive failure to complete medical records was rated as "mildly serious." A resident with "less serious" professionalism issues was also felt to be likely to have "serious" or "critical" issues "often" (33.8% of respondents) or "always" (6.5%). The most common methods of assessment were clinical/advisor evaluations. However, existing assessment methods were described as inadequate in identifying serious professionalism issues by 50.7% of responding PDs. Unprofessionalism was most commonly discovered by unofficial faculty complaint (54.5%). Eighty percent report that professionalism is more difficult to remediate than other core competencies. Resident ownership of the problem was reported as most critical to remediation

  2. Postneoliberal Public Health Care Reforms: Neoliberalism, Social Medicine, and Persistent Health Inequalities in Latin America.

    PubMed

    Hartmann, Christopher

    2016-12-01

    Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models. Postneoliberal reforms may provide an alternative means of reducing health inequalities and improving population health.

  3. Can emergency medicine research benefit from adaptive design clinical trials?

    PubMed

    Flight, Laura; Julious, Steven A; Goodacre, Steve

    2017-04-01

    Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013. We determined the proportion that used an adaptive design as well as the proportion that could have used a simple adaptive design based on the time to primary outcome and length of recruitment. Only 19 of 188 trials included in the review were considered to have used an adaptive trial design. A total of 154/165 trials that were fixed in design had the potential to use an adaptive design. Currently, there seems to be limited uptake in the use of adaptive trial designs in emergency medicine despite their potential benefits to save time and resources. Failing to take advantage of adaptive designs could be costly to patients and research. It is recommended that where practical and logistical considerations allow, adaptive designs should be used for all emergency medicine clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. A bibliometric analysis of research productivity of emergency medicine researchers in South Korea

    PubMed Central

    Choi, Jiun; You, Je Sung; Joo, Young Seon; kong, Taeyoung; Ko, Dong Ryul; Chung, Sung Phil

    2016-01-01

    Objective During the past 20 years, over 1,400 doctors have been certified as emergency physicians in Korea. The number of scientific publications in the field of emergency medicine has also increased. This study aims to evaluate the research productivity of academic emergency physicians in South Korea. Methods Articles published from 1996 to 2015 by authors affiliated with Korean emergency departments were retrieved using Pubmed, Embase, and Web of Science. Research productivity was analyzed quantitatively to ascertain the number of articles for publication type and year. The performance of these articles was also analyzed qualitatively using impact factor, citation number, and Hirsch index. Bibliometric analysis was performed by researching Web of Science, Scopus, and Google Scholar. Results A total of 858 articles with 293 Korean authors as the first or corresponding authors were published across 191 journals. The number of publications increased continuously. The most common publication type was original article (n=618), the most commonly studied research topic was resuscitation medicine (n=110), and the average impact factor of the original articles was 2.158. The highest h-index was 17 and, using Web of Science, the maximum number of citations was found to be 85. Conclusion This study suggests that the research productivity of Korean authors in the emergency medicine field has progressed steadily during the last 10 years. However, qualitative indexes, such as the number of citations and h-index value, remain low. PMID:28168231

  5. Public health and community medicine instruction and physician practice location.

    PubMed

    Xierali, Imam M; Maeshiro, Rika; Johnson, Sherese; Arceneaux, Taniecea; Fair, Malika A

    2014-11-01

    Experts have historically recommended better integration of public health content into medical education. Whether this adoption is associated with physician practice location has not been studied. To examine the association between medical student perception of their public health and community medicine instruction and practice location in a Health Professional Shortage Area. Descriptive analysis and a regression model assessed the significance and strength of the association between medical student perception of their public health and community medicine instruction and practice location using data from the Medical School Graduation Questionnaire 1997-2004, 2013 American Medical Association Physician Masterfile, and 2013 Health Professional Shortage Areas. A higher proportion of medical students with an intent to practice in underserved areas reported inadequate instruction in public health and community medicine than those without such intentions. Students reporting adequate public health and community medicine instruction are slightly more likely to practice in a Health Professional Shortage Area, controlling for their intent to practice in underserved areas. Findings suggest an association between perceptions of public health and community medicine instruction and practice location. Improved public health and community medicine instruction may support medical students' preparation and ability to integrate public health skills into practices in underserved settings. More research is needed to ascertain factors enabling better incorporation of public health and community medicine in medical education. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Emergency department overcrowding – implications for paediatric emergency medicine

    PubMed Central

    Sinclair, Douglas

    2007-01-01

    Emergency department (ED) overcrowding has been an international phenomenon for more than 10 years. It is important to understand that ED overcrowding is a measure of health system efficiency and is not strictly related to ED volumes or capacity. ED overcrowding is defined as a situation in which the demand for emergency services exceeds the ability of physicians and nurses to provide quality care within a reasonable time. The major factor resulting in ED overcrowding is the presence of admitted patients in the ED for prolonged periods of time, not a high volume of low-acuity patients. While limited data are available for paediatric EDs, winter respiratory illnesses set the stage for ED overcrowding, which are epidemic in adult or general EDs. Prehospital-, ED- and hospital-related factors are described in the present article, and these may help prevent or manage this important patient safety problem. PMID:19030415

  7. Withholding and withdrawing medical treatment: an emergency medicine perspective.

    PubMed

    Iserson, K V

    1996-07-01

    In emergency medicine, a significant difference rightfully persists between the withholding and withdrawal of life-sustaining medical treatment. The justification for this difference stems part from the nature of emergency medical practice and the unique manner in which clinicians apply many ethical principles. In the usual setting, the decision to withhold further medical treatment is done quietly, often without input from the patients surrogate decisionmaker, whereas withdrawal of ongoing medical treatment can be more obvious and difficult. This situation is reversed in the emergency medicine setting. The withholding of emergency medical treatment is much more problematic than later withdrawal of unwanted or useless interventions. Emergency physicians and prehospital providers often lack vital information about their patients' identities, medical conditions, and wishes. Society also has specific expectations of emergency physicians. Because of the nature of emergency medicine, both in the prehospital and the emergency department settings, the distinction between withdrawal and withholding of medical treatment has never disappeared and is not likely to do so in the future.

  8. [Development of Social Medicine and Public Health in Germany].

    PubMed

    Wildner, M; Niehoff, J-U; Hoffmann, W

    2016-02-01

    Social medicine in Germany has multiple lines of tradition, which are marked by the presence of 2 German states and their re-unification and by the (re-)establishment of multidisciplinary public health by the end of the twentieth century. At the same time, a differentiation within the applied fields of social medicine into several thematic topics can be observed. These can be grouped in a first step into the domains of clinical social medicine, of social medicine for social insurance purposes and of a population-oriented social medicine. For social medicine as a scientific discipline within the broad context of medicine, the requirement of a context-adequate development, which encompasses the special methods of multidisciplinary public health, poses big challenges. For successfully meeting these challenges and going beyond population-oriented public health and for bridging the gap between the individual and the social medical institutions of the health system, it is indispensable for social medicine to be independent of other disciplines within the array of medical specialties. The present study argues for strengthening social medicine within the medical faculties. Chairs for social medicine and public health are not only in the interest of the applied fields of social medicine, but represent also an indispensable scientific discipline which can relate and contribute to all specialties of medicine. © Georg Thieme Verlag KG Stuttgart · New York.

  9. The use of nuclear medicine techniques in the emergency department

    PubMed Central

    McGlone, B; Balan, K

    2001-01-01

    Nuclear medicine techniques have received little attention in the practice of emergency medicine, yet radionuclide imaging can provide valuable and unique information in the management of acutely ill patients. In this review, emphasis is placed on the role of these techniques in patients with bone injuries, non-traumatic bone pain and in those with pleuritic chest pain. New developments such as single photon emission computed tomography (SPECT) in myocardial infarction are outlined and older techniques such as scrotal scintigraphy are reviewed. Radionuclide techniques are discussed in a clinical context and in relation to alternative imaging modalities or strategies that may be available to the emergency medicine physician. Aspects of a 24 hour nuclear medicine service are considered. PMID:11696487

  10. Nanotechnology: emerging tools for biology and medicine

    PubMed Central

    Wong, Ian Y.; Bhatia, Sangeeta N.; Toner, Mehmet

    2013-01-01

    Historically, biomedical research has been based on two paradigms. First, measurements of biological behaviors have been based on bulk assays that average over large populations. Second, these behaviors have then been crudely perturbed by systemic administration of therapeutic treatments. Nanotechnology has the potential to transform these paradigms by enabling exquisite structures comparable in size with biomolecules as well as unprecedented chemical and physical functionality at small length scales. Here, we review nanotechnology-based approaches for precisely measuring and perturbing living systems. Remarkably, nanotechnology can be used to characterize single molecules or cells at extraordinarily high throughput and deliver therapeutic payloads to specific locations as well as exhibit dynamic biomimetic behavior. These advances enable multimodal interfaces that may yield unexpected insights into systems biology as well as new therapeutic strategies for personalized medicine. PMID:24240230

  11. Nanotechnology: emerging tools for biology and medicine.

    PubMed

    Wong, Ian Y; Bhatia, Sangeeta N; Toner, Mehmet

    2013-11-15

    Historically, biomedical research has been based on two paradigms. First, measurements of biological behaviors have been based on bulk assays that average over large populations. Second, these behaviors have then been crudely perturbed by systemic administration of therapeutic treatments. Nanotechnology has the potential to transform these paradigms by enabling exquisite structures comparable in size with biomolecules as well as unprecedented chemical and physical functionality at small length scales. Here, we review nanotechnology-based approaches for precisely measuring and perturbing living systems. Remarkably, nanotechnology can be used to characterize single molecules or cells at extraordinarily high throughput and deliver therapeutic payloads to specific locations as well as exhibit dynamic biomimetic behavior. These advances enable multimodal interfaces that may yield unexpected insights into systems biology as well as new therapeutic strategies for personalized medicine.

  12. Assessing interpersonal and communication skills in emergency medicine.

    PubMed

    Chan, Teresa M; Wallner, Clare; Swoboda, Thomas K; Leone, Katrina A; Kessler, Chad

    2012-12-01

    Interpersonal and communication skills (ICS) are a key component of several competency-based schemata and key competency in the set of six Accreditation Council for Graduate Medical Education (ACGME) core competencies. With the shift toward a competency-based educational framework, the importance of robust learner assessment becomes paramount. The journal Academic Emergency Medicine (AEM) hosted a consensus conference to discuss education research in emergency medicine (EM). This article summarizes the initial preparatory research that was conducted to brief consensus conference attendees and reports the results of the consensus conference breakout session as it pertains to ICS assessment of learners. The goals of this consensus conference session were to twofold: 1) to determine the state of assessment of observable learner performance and 2) to determine a research agenda within the ICS field for medical educators. The working group identified six key recommendations for medical educators and researchers. © 2012 by the Society for Academic Emergency Medicine.

  13. Emergency medicine and psychiatry agreement on diagnosis and disposition of emergency department patients with behavioral emergencies.

    PubMed

    Douglass, Amy M; Luo, John; Baraff, Larry J

    2011-04-01

    The objective was to determine the level of agreement between emergency physicians (EPs) and consulting psychiatrists in their diagnosis and disposition of emergency department (ED) patients with behavioral emergencies. The authors conducted a prospective study at a university teaching hospital ED with an annual census of approximately 45,000 patients. During study hours, each time a psychiatric consultation was requested, the emergency medicine (EM) and consulting psychiatry residents were asked to fill out similar short questionnaires concerning their diagnoses and disposition decisions after they consulted with their attending physicians. EM and psychiatry residents were blinded to the other's assessment of the patient. Residents were asked about their evaluation of patients regarding: 1) psychiatric assessments, 2) if the patients presented a danger to themselves or others or were gravely disabled, and 3) the need for emergency psychiatric hospitalization. A total of 408 resident physician pairs were enrolled in the study. Patients ranged in age from 5 to 92 years, with a median age of 31 years; 50% were female. The most common psychiatric assessments, as evaluated by either EPs, consulting psychiatrists, or both, were mood disorder (66%), suicidality (57%), drug/alcohol abuse (26%), and psychosis (25%). Seventy-three percent were admitted for acute psychiatric hospitalization. Agreement between EPs and psychiatrists was 67% for presence of mood disorder, 82% for suicidality, 82% for drug/alcohol abuse, 85% for psychosis, and 85% for grave disability. There was 67% agreement regarding patient eligibility for involuntary psychiatric hold. EPs felt confident enough to make disposition decisions 87% of the time; for these patients there was 76% agreement with consulting psychiatrists about the final disposition decision. The 67% agreement between EPs and consulting psychiatrists regarding need for involuntary hold, and 76% agreement regarding final disposition

  14. Homeopathic treatment in emergency medicine: a case series.

    PubMed

    Oberbaum, M; Schreiber, R; Rosenthal, C; Itzchaki, M

    2003-01-01

    Following a multiple-casualty construction disaster in Israel, members of The Center of Integrated Complementary Medicine joined in the emergency activity of the Shaare Zedek Medical Center. They administered homeopathic treatment to injured patients to supplement conventional orthopaedic treatment. This was to our knowledge the first time that complementary medicine had been used officially in conjunction with conventional medicine in an emergency situation. Our objective is to report and summarize the rationale, procedures and outcome of the complementary medicine intervention. Fifteen orthopaedic patients were included. They were treated by homeopathy in two phases starting 24 h post-trauma. All patients initially received Arnica montana 200CH in a single dose. Anxiety was treated with Aconite 200CH in nine patients, Opium 200CH in three, Ignatia 200CH in two and Arsenicum album 200CH in one according to type of anxiety. One day later, most patients reported a lessening of pain, 58% felt improvement, 89% had reduced anxiety, and overall, 61% felt that homeopathic treatment was helpful. In the second phase, 48 h post-trauma, specific complaints were addressed with classical homeopathy. At discharge patients rated the homeopathic treatment successful in 67% of the specific complaints. Several issues relating to the use of homeopathy in emergency medicine and its relation to conventional treatment are discussed. These include compliance, the conduct of rounds, shortage of time and staff, and the procurement of medicines.

  15. Randomized Trials in Emergency Medicine Journals, 2008-2011

    PubMed Central

    Jones, Christopher W.; Hunold, Katherine M.; Isaacs, Cameron G.; Platts-Mills, Timothy F.

    2012-01-01

    Study Objective Knowledge of current areas of activity in emergency medicine research may improve collaboration among investigators and may help inform decisions about future research priorities. Randomized controlled trials are a key component of research activity and an essential tool for improving care. We investigated the characteristics of randomized trials recently published in emergency medicine journals. Methods This was a retrospective analysis of randomized trials published in the five highest-impact emergency medicine journals. Pubmed was searched for reports of randomized trials involving human subjects indexed to MEDLINE between January 1, 2008 and December 31, 2011. Included trials were classified with respect to study topic, funding source, presence of age-related inclusion criteria, and country of origin. Results 163 published studies were included for analysis. Pain management was the most commonly studied topic (N=28, 17%) followed by orthopedics (N = 24, 15%), cardiovascular disease (N=13, 8%), and pre-hospital medicine (N=13, 8%). Less than half of studies received extramural funding support. Children were specifically examined in 22 (13%) of trials; only 5 trials (3%) specifically examined patients age 60 or older. Conclusions Emergency medicine journals publish randomized trials addressing a wide range of clinical topics. Randomized trials focusing on geriatric patients are not commonly published in these journals. PMID:22867836

  16. Systems Medicine as an Emerging Tool for Cardiovascular Genetics

    PubMed Central

    Haase, Tina; Börnigen, Daniela; Müller, Christian; Zeller, Tanja

    2016-01-01

    Cardiovascular disease (CVD) is a major contributor to morbidity and mortality worldwide. However, the pathogenesis of CVD is complex and remains elusive. Within the last years, systems medicine has emerged as a novel tool to study the complex genetic, molecular, and physiological interactions leading to diseases. In this review, we provide an overview about the current approaches for systems medicine in CVD. They include bioinformatical and experimental tools such as cell and animal models, omics technologies, network, and pathway analyses. Additionally, we discuss challenges and current literature examples where systems medicine has been successfully applied for the study of CVD. PMID:27626034

  17. Emergency medicine: an operations management view.

    PubMed

    Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

    2011-12-01

    Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider.

  18. The association between money and opinion in academic emergency medicine.

    PubMed

    Birkhahn, Robert H; Blomkalns, Andra; Klausner, Howard; Nowak, Richard; Raja, Ali S; Summers, Richard; Weber, Jim E; Briggs, William M; Arkun, Alp; Diercks, Deborah

    2010-05-01

    Financial conflicts of interest have come under increasing scrutiny in medicine, but their impact has not been quantified. Our objective was to use the results of a national survey of academic emergency medicine (EM) faculty to determine if an association between money and personal opinion exists. We conducted a web-based survey of EM faculty. Opinion questions were analyzed with regard to whether the respondent had either 1) received research grant money or 2) received money from industry as a speaker, consultant, or advisor. Responses were unweighted, and tests of differences in proportions were made using Chi-squared tests, with p<0.05 set for significance. We received responses from 430 members; 98 (23%) received research grants from industry, while 145 (34%) reported fee-for-service money. Respondents with research money were more likely to be comfortable accepting gifts (40% vs. 29%) and acting as paid consultants (50% vs. 37%). They had a more favorable attitude with regard to societal interactions with industry and felt that industry-sponsored lectures could be fair and unbiased (52% vs. 29%). Faculty with fee-for-service money mirrored those with research money. They were also more likely to believe that industry-sponsored research produces fair and unbiased results (61% vs. 45%) and less likely to believe that honoraria biased speakers (49% vs. 69%). Accepting money for either service or research identified a distinct population defined by their opinions. Faculty engaged in industry-sponsored research benefitted socially (collaborations), academically (publications), and financially from the relationship.

  19. China's research status in emergency medicine: a 15-year survey of literature.

    PubMed

    Wang, Weiwei; Jiang, Ting; Li, Chunyu; Chen, Jun; Cao, Kejiang; Qi, Lian-wen; Li, Ping; Zhu, Wei; Zhu, Baoli; Chen, Yan

    2016-03-01

    To investigate the research status of emergency medicine in China through literature search of international emergency medicine journals and retrospectively compare the outputs of emergency medicine articles of the 3 major regions of China-Mainland (ML), Taiwan (TW), and Hong Kong (HK). Emergency medicine journals were selected category from Science Citation Index Expand. Articles from the ML, TW, and HK were retrieved from PubMed database. The total number of articles, publication types, research contents, impact factors (IF), and articles published in each journal were conducted for quantity and quality comparisons. A total of 1760 articles from 19 emergency medicine journals were searched, of which 395 were from ML, 1210 from TW, and 155 from HK. Accumulated IF of articles from TW (2451.109) was much higher than that of ML (851.832) and HK (328.579), whereas the average IF of articles from TW (2.02) was the lowest. The number of case reports was the highest, which was, 69 from ML, 637 from TW, and 25 from HK, respectively. Although emergency medicine was involved with multiple organs and multiple systems, the reports of trauma accounted for 25% of the research contents. The total number of articles from both China and the rest of the world increased significantly from 2000 to 2014, especially ML. The total number of articles from TW was still much more than that of ML and HK, whereas the quality of articles from TW was not as good as ML and HK. Case report had the highest share of publication types, whereas the proportions of meta-analysis and observational study were the lowest. As for research contents, the proportion of trauma was still the highest. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Geographic information systems in public health and medicine.

    PubMed

    Mullner, Ross M; Chung, Kyusuk; Croke, Kevin G; Mensah, Edward K

    2004-06-01

    Geographic information systems (GIS) are increasingly being used in public health and medicine. Advances in computer technology, the encouragement of its use by the federal government, and the wide availability of academic and commercial courses on GIS are responsible for its growth. Some view GIS as only a tool for spatial research and policy analysis, while others believe it is part of a larger emerging new science including geography, cartography, geodesy, and remote sensing. The specific advantages and problems of GIS are discussed. The greatest potential of GIS is its ability to clearly show the results of complex analyses through maps. Problems in using GIS include its costs, the need to adequately train staff, the use of appropriate spatial units, and the risk it poses to violating patient confidentiality. Lastly, the fourteen articles in this special issue devoted to GIS are introduced and briefly discussed.

  1. Emergency medicine systems advancement through community-based development.

    PubMed

    Bloem, Martha M; Bloem, Christina M; Rosentsveyg, Juliana; Arquilla, Bonnie

    2014-02-01

    Humanitarian health programs frequently focus on immediate relief and are supply side oriented or donor driven. More emphasis should be placed on long-term development projects that engage local community leaders to ensure sustainable change in health care systems. With the Emergency Medicine Educational Exchange (EMEDEX) International Rescue, Recover, Rebuild initiative in Northeast Haiti as a model, this paper discusses the opportunities and challenges in using community-based development to establish emergency medical systems in resource-limited settings.

  2. Key articles and guidelines for the emergency medicine pharmacist.

    PubMed

    Thomas, Michael C; Acquisto, Nicole M; Patanwala, Asad E; Weant, Kyle A; Baker, Stephanie N

    2011-12-01

    Abstract Compilations of articles important to the pharmacist practicing in the emergency department have not been published. Consistent with other specialty areas of practice, a collection of important literature is valuable for both the new and experienced clinician. A diverse breadth of medical problems are represented that were felt to be the most pertinent issues facing the emergency medicine pharmacist; however, it is not intended to be a complete representation of available literature.

  3. [Value of lung ultrasound in emergency and intensive care medicine].

    PubMed

    Michels, G; Breitkreutz, R; Pfister, R

    2014-11-01

    Lung ultrasound has traditionally been limited to evaluation of pleural effusion and as guidance for thoracocentesis. However, in recent years, thoracic ultrasound became an increasingly valuable diagnostic tool in emergency and intensive care medicine. The relative easy use of bedside examination made chest ultrasonography diagnostic valuable additional tool to be used in any clinical acute context. Various pulmonary diseases like pleural effusion, pulmonary-venous congestion und edema, pneumonia and pneumothorax can be detected very fast under emergency conditions.

  4. Emergency medicine-quality indicators: the United Kingdom perspective.

    PubMed

    Heyworth, John

    2011-12-01

    During the 1990s, relentlessly increasing emergency department (ED) attendances in the United Kingdom led to major dysfunction and ED overcrowding. The situation was exacerbated by outdated ED design, inadequate ED capacity, traditional ED processes, a predominantly junior doctor-based workforce, and insufficient in-hospital beds for patients requiring admission. The crisis led to high-profile lobbying by the U.K. emergency medicine body (British Association for Emergency Medicine) and in the populist media. This led to the Reforming Emergency Care initiative and the 4-hour target. This article describes the benefits and disadvantages associated with a single time-related measure of ED performance. The article also describes the subsequent development of a raft of quality indicators designed to provide a greater breadth of ED measurement, reflecting timeliness, quality, and safety. The intention is for these indicators to act as levers for change and to generate a program of continuing improvement in emergency care. The indicators were introduced in England in April 2011, and currently there is a period of bedding-in and collective learning. The quality indicators will be reviewed and refined as required, with any amendments introduced in April 2012. © 2011 by the Society for Academic Emergency Medicine.

  5. An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine.

    PubMed

    Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

    2017-07-01

    Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Predictors of a Top Performer During Emergency Medicine Residency.

    PubMed

    Bhat, Rahul; Takenaka, Katrin; Levine, Brian; Goyal, Nikhil; Garg, Manish; Visconti, Annette; Oyama, Leslie; Castillo, Edward; Broder, Joshua; Omron, Rodney; Hayden, Stephen

    2015-10-01

    Emergency Medicine (EM) residency program directors and faculty spend significant time and effort creating a residency rank list. To date, however, there have been few studies to assist program directors in determining which pre-residency variables best predict performance during EM residency. To evaluate which pre-residency variables best correlated with an applicant's performance during residency. This was a retrospective multicenter sample of all residents in the three most recent graduating classes from nine participating EM residency programs. The outcome measure of top residency performance was defined as placement in the top third of a resident's graduating class based on performance on the final semi-annual evaluation. A total of 277 residents from nine institutions were evaluated. Eight of the predictors analyzed had a significant correlation with the outcome of resident performance. Applicants' grade during home and away EM rotations, designation as Alpha Omega Alpha (AOA), U.S. Medical Licensing Examination (USMLE) Step 1 score, interview scores, "global rating" and "competitiveness" on nonprogram leadership standardized letter of recommendation (SLOR), and having five or more publications or presentations showed a significant association with residency performance. We identified several predictors of top performers in EM residency: an honors grade for an EM rotation, USMLE Step 1 score, AOA designation, interview score, high SLOR rankings from nonprogram leadership, and completion of five or more presentations and publications. EM program directors may consider utilizing these variables during the match process to choose applicants who have the highest chance of top performance during residency. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Essentials of Pediatric Emergency Medicine Fellowship: Part 1: An Overview.

    PubMed

    Zaveri, Pavan P; Hsu, Deborah; Mittiga, Matthew R; Wolff, Margaret; Reynolds, Stacy; Kim, In; Allen, Coburn; McAneney, Constance M; Kou, Maybelle

    2016-05-01

    This article is the first in a 7-part series (Table 1) that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated on program completion. This overview article provides a framework for the series.

  8. An eMERGE Clinical Center at Partners Personalized Medicine.

    PubMed

    Smoller, Jordan W; Karlson, Elizabeth W; Green, Robert C; Kathiresan, Sekar; MacArthur, Daniel G; Talkowski, Michael E; Murphy, Shawn N; Weiss, Scott T

    2016-01-20

    The integration of electronic medical records (EMRs) and genomic research has become a major component of efforts to advance personalized and precision medicine. The Electronic Medical Records and Genomics (eMERGE) network, initiated in 2007, is an NIH-funded consortium devoted to genomic discovery and implementation research by leveraging biorepositories linked to EMRs. In its most recent phase, eMERGE III, the network is focused on facilitating implementation of genomic medicine by detecting and disclosing rare pathogenic variants in clinically relevant genes. Partners Personalized Medicine (PPM) is a center dedicated to translating personalized medicine into clinical practice within Partners HealthCare. One component of the PPM is the Partners Healthcare Biobank, a biorepository comprising broadly consented DNA samples linked to the Partners longitudinal EMR. In 2015, PPM joined the eMERGE Phase III network. Here we describe the elements of the eMERGE clinical center at PPM, including plans for genomic discovery using EMR phenotypes, evaluation of rare variant penetrance and pleiotropy, and a novel randomized trial of the impact of returning genetic results to patients and clinicians.

  9. The intersecting paradigms of naturopathic medicine and public health: opportunities for naturopathic medicine.

    PubMed

    Wardle, Jon; Oberg, Erica B

    2011-11-01

    Complementary medicine research, including naturopathic medicine research, is plagued with many methodological challenges. Many of these challenges have also been experienced in public health research. Public health research has met these challenges with a long history of multidisciplinary, multimethod, and whole systems approaches to research that may better resonate with the ?real world? clinical settings of naturopathic medicine. Additionally, many of the underlying principles of naturopathic medicine are analogous to the underlying principles and activities of public health, specifically in such areas as health promotion, prevention, patient education, and proactive rather than reactive approaches to disease management and treatment. Future research in the field of naturopathic medicine may benefit from adopting public health research models rather than focusing exclusively on biomedical models. A complementary and collaborative relationship between these fields may provide an opportunity to deliver research that more accurately reflects naturopathic medicine practice, as well as providing the opportunity to improve health outcomes more generally.

  10. Diagnosis of public programs focused on herbal medicines in Brazil.

    PubMed

    Camargo, Ely Eduardo Saranz; Bandeira, Mary Anne Medeiros; de Oliveira, Anselmo Gomes

    2011-07-01

    The present study is aimed to diagnose the current public programs focused on herbal medicines in Brazil by means of in loco visits to 10 programs selected by means of questionnaires sent to 124 municipalities that count on herbal medicine services. The main purpose of the implementation of program programs is related to the development of medicinal herbs. 70% of them are intended for the production of herbal medicines and 50% are aimed to ensure the access of the population to medicinal plants and or herbal medicines. The initiative of the implementation of these programs was related to the managers (60%). The difficulties in this implementation were due to the lack of funding (100%) of the programs. In 60% of the programs, the physicians did not adhere to herbal medicine services due to the lack of knowledge of the subject. Training courses were proposed (80%) to increase the adhesion of prescribers to the system. Some municipalities use information obtained from patients to assess the therapeutic efficiency of medicinal plants and herbal medicines. Of the programs underway, cultivation of medicinal plants was observed in 90% and 78% of them adopt quality control. In most programs, this control is not performed in accordance with the legal requirements. The programs focused on medicinal plants and herbal medicines implemented in Brazil face some chronic problems of infrastructure, management, operational capacity and self-sustainability, which can be directly related to the absence of a national policy on medicinal plants and herbal medicines.

  11. A rational approach to shift work in emergency medicine.

    PubMed

    Whitehead, D C; Thomas, H; Slapper, D R

    1992-10-01

    As the only medical specialists who routinely provide continuous 24-hour daily coverage, emergency physicians are all too familiar with the demands of shift work. Although shift work has a pervasive effect on the practice of emergency medicine and is regarded as a major stressor, it has received little attention per se in our literature and in our residency training programs. We review the principles of circadian rhythms and their effects on sleep and alertness, and recommend ways by which emergency physicians can better schedule themselves to mitigate the negative consequences of working shifts.

  12. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

    PubMed Central

    Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie

    2016-01-01

    Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434

  13. Job market survey of recent pediatric emergency medicine fellowship graduates.

    PubMed

    Vu, Tien T; Hampers, Louis C; Joseph, Madeline M; Connors, Michael J; Gerardi, Michael; Inkelis, Stanley H; Shook, Joan E

    2007-05-01

    The American Academy of Pediatrics Section of Emergency Medicine's Subcommittee on Administration developed a survey tool targeting recent pediatric emergency medicine (PEM) fellowship graduates to assess the current PEM job market in a variety of areas including (1) the new positions accepted, (2) perspectives of fellowship training, and (3) the relationship between PEM and general emergency medicine practice. The 40-question internet-based survey was developed through www.surveymonkey.com. Solicitations to PEM fellowship graduates who completed training between the years 2000 and 2005 were sent via the Section of Emergency Medicine member e-mail list as well as the PEM LISTSERV. Data collection occurred from April to May 2005. Of 125 survey respondents, 89% completed a 3-year pediatrics residency plus a 3-year PEM fellowship. Offers to graduates of positions with research expectations outnumbered clinical positions, 3:2, with an average of 5 total positions offered per respondent. Thirty-four percent remained at the institution of fellowship graduation, and 71% accepted faculty appointments with medical school affiliation. Seventy percent of work time was spent on clinical duties and 10% on research. Most felt better prepared in the areas of clinical training and teaching than in the areas of research and administration. Additional general emergency medicine exposure was not desired. Half of the respondents felt that a 2-year fellowship program would have met their career goals. Recent PEM fellowship graduates felt that job availability was good and were satisfied with their new positions. Respondents perceived better fellowship training in clinical and teaching aspects than in research and administration. New positions were heavily clinical and matched career goals.

  14. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.

    PubMed

    Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie

    2016-07-01

    Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.

  15. Patient and public involvement in emergency care research.

    PubMed

    Hirst, Enid; Irving, Andy; Goodacre, Steve

    2016-09-01

    Patients participate in emergency care research and are the intended beneficiaries of research findings. The public provide substantial funding for research through taxation and charitable donations. If we do research to benefit patients and the public are funding the research, then patients and the public should be involved in the planning, prioritisation, design, conduct and oversight of research, yet patient and public involvement (or more simply, public involvement, since patients are also members of the public) has only recently developed in emergency care research. In this article, we describe what public involvement is and how it can help emergency care research. We use the development of a pioneering public involvement group in emergency care, the Sheffield Emergency Care Forum, to provide insights into the potential and challenges of public involvement in emergency care research.

  16. Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?

    PubMed

    Limkakeng, Alexander T; Monte, Andrew A; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L; Shapiro, Nathan I

    2016-10-01

    Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users. © 2016 by the Society for Academic Emergency Medicine.

  17. The use of simulation in emergency medicine: a research agenda.

    PubMed

    Bond, William F; Lammers, Richard L; Spillane, Linda L; Smith-Coggins, Rebecca; Fernandez, Rosemarie; Reznek, Martin A; Vozenilek, John A; Gordon, James A

    2007-04-01

    Medical simulation is a rapidly expanding area within medical education. In 2005, the Society for Academic Emergency Medicine Simulation Task Force was created to ensure that the Society and its members had adequate access to information and resources regarding this new and important topic. One of the objectives of the task force was to create a research agenda for the use of simulation in emergency medical education. The authors present here the consensus document from the task force regarding suggested areas for research. These include opportunities to study reflective experiential learning, behavioral and team training, procedural simulation, computer screen-based simulation, the use of simulation for evaluation and testing, and special topics in emergency medicine. The challenges of research in the field of simulation are discussed, including the impact of simulation on patient safety. Outcomes-based research and multicenter efforts will serve to advance simulation techniques and encourage their adoption.

  18. Preliminary elaboration on emergent properties of traditional Chinese medicine.

    PubMed

    Chai, Xing-yun

    2015-07-01

    Plant and animal derived secondary metabolites are the result of initiative and adaptability of natural evolution due to its adaptive stress responses. Based on countless attempts, rational thinking and thousands of years of clinical practice by ancient Chinese, the medicines were endowed with advantages for the treatment of diseases and keeping health balance through multiple components combination instead of single components, featured by a complex system with emergent properties. The emergence of traditional Chinese medicine is because of the integration of various components and its complex interactions. How to obtain the new multicomponent entities with the biological equivalent effect is an important and fundamental work for TCM-based new drug research and development. Currently, recognition of TCM emergence and development of related technical methods needs strengthened, and the understanding and research of TCM require a systematic integration of the holistic and reductive methods.

  19. [Quantitative analysis of the demand for emergency medicine in Yokohama City, Japan].

    PubMed

    Ohshige, Kenji; Ii, Masako; Nawata, Kazumitsu; Mizushima, Shunsaku; Tochikubo, Osamu

    2003-09-01

    We analyzed regional characteristics that potentially might affect regional demand for emergency medicine in Yokohama city and projected the number of future ambulance users. The number of patients transported by ambulance was regarded as an index of the demand for emergency medicine. Various factors that may affect regional demand for emergency medicine were used as dependent variables in multiple regression analysis. The future population was estimated by the cohort change rate method based on the 1995 and 2000 censuses. Data pertaining to ambulance use were obtained from the Annual Fire Fighting Bulletin, Yokohama. Data pertaining to regional factors were obtained from the Annual Health Statistics Report, Yokohama; the Annual Health Statistics Report, Kanagawa; and the Statistics Report, Yokohama. Statistically significant relations were observed between ambulance use per 1000 population and particular regional characteristics, i.e. the proportion of persons undergoing health examinations conducted by public health centers, the number of educational health promotion programs managed by the public sector, the proportion of persons in receipt of livelihood protection, the proportions of roads and commercial areas in each district in relation to the total area, the mean land price, the age-adjusted mortality rate, and the proportion of persons aged 65 years or over. The demand for emergency medicine in Yokohama city was predicted to increase dramatically as the population ages. The number of patients transported by ambulance, which was 121,606 in 2000, was projected to exceed 250,000 in 2030 and to approximate 300,000 in 2050. The demand for emergency medicine will increase dramatically in Yokohama city as the society ages, Regional emergency medical systems should be improved accordingly.

  20. Differences between family and emergency medicine training before sports medicine fellowship.

    PubMed

    Christensen, Mark; Christensen, Heidi K

    2015-01-01

    Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps.

  1. Development of a novel sports medicine rotation for emergency medicine residents

    PubMed Central

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students’ and residents’ musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their

  2. Development of a novel sports medicine rotation for emergency medicine residents.

    PubMed

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

  3. The Society for Academic Emergency Medicine and Association of Academic Chairs in Emergency Medicine 2009-2010 emergency medicine faculty salary and benefits survey.

    PubMed

    Watts, Susan H; Promes, Susan B; Hockberger, Robert

    2012-07-01

    he objective was to report the results of a survey conducted jointly by the Society for Academic Emergency Medicine (SAEM) and the Association of Academic Chairs in Emergency Medicine (AACEM) of faculty salaries, benefits, work hours, and department demographics for institutions sponsoring residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee for Emergency Medicine (RRC-EM). Data represent information collected for the 2009-2010 academic year through an electronic survey developed by SAEM and AACEM and distributed by the Office for Survey Research at the University of Michigan to all emergency department (ED) chairs and chiefs at institutions sponsoring accredited residency programs. Information was collected regarding faculty salaries and benefits; clinical and nonclinical work hours; sources of department income and department expenses; and selected demographic information regarding faculty, EDs, and hospitals. Salary data were sorted by program geographic region and faculty characteristics such as training and board certification, academic rank, department title, and sex. Demographic data were analyzed with regard to numerous criteria, including ED staffing levels, patient volumes and length of stay, income sources, salary incentive components, research funding, and specific type and value of fringe benefits offered. Data were compared with previous SAEM studies and the most recent faculty salary survey conducted by the Association of American Medical Colleges (AAMC). Ninety-four of 155 programs (61%) responded, yielding salary data on 1,644 faculty, of whom 1,515 (92%) worked full-time. The mean salary for all faculty nationwide was $237,884, with the mean ranging from $232,819 to $246,853 depending on geographic region. The mean salary for first-year faculty nationwide was $204,833. Benefits had an estimated mean value of $48,915 for all faculty, with the mean ranging from $37,813 to $55

  4. American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2016-2017).

    PubMed

    Marco, Catherine A; Nelson, Lewis S; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Chudnofsky, Carl R; Gausche-Hill, Marianne; Goyal, Deepi G; Keim, Samuel M; Kowalenko, Terry; Muelleman, Robert L; Joldersma, Kevin B

    2017-05-01

    The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2017 annual report on the status of US emergency medicine training programs. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  5. Human factors and error prevention in emergency medicine.

    PubMed

    Bleetman, Anthony; Sanusi, Seliat; Dale, Trevor; Brace, Samantha

    2012-05-01

    Emergency departments are one of the highest risk areas in health care. Emergency physicians have to assemble and manage unrehearsed multidisciplinary teams with little notice and manage critically ill patients. With greater emphasis on management and leadership skills, there is an increasing awareness of the importance of human factors in making changes to improve patient safety. Non-clinical skills are required to achieve this in an information-poor environment and to minimise the risk of errors. Training in these non-clinical skills is a mandatory component in other high-risk industries, such as aviation and, needs to be part of an emergency physician's skill set. Therefore, there remains an educational gap that we need to fill before an emergency physician is equipped to function as a team leader and manager. This review will examine the lessons from aviation and how these are applicable to emergency medicine. Solutions to averting errors are discussed and the need for formal human factors training in emergency medicine.

  6. Sports medicine training and practice opportunities for emergency physicians.

    PubMed

    Henehan, Michael J; Cappellari, Ann M; Stromwall, Amy E; Donaldson, Nathan G

    2013-10-01

    There is growing interest among emergency physicians to seek additional training in Sports Medicine (SM) and to add it to their clinical practice. This presents unique training and practice management issues. The majority of Primary Care SM fellowship programs list that they will accept emergency physicians, and approximately one-third have already had an emergency physician as an SM fellow. The objective of this article is to provide an overview of the key elements for emergency physicians to consider as they pursue SM career goals. Training needs such as continuity of care as it pertains to the athlete, SM skills development, and practice management are reviewed. Practice challenges such as malpractice insurance and billing issues are discussed. Examples of several practice models are presented. Evolving trends in SM practice and training opportunities for emergency physicians are discussed as well. Sports Medicine is a viable career option for emergency physicians and may complement their skills set in the management of acute injuries. Practice and training opportunities will continue to evolve as this pathway into the practice of SM gains further recognition. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Emergence of cooperation in public goods games.

    PubMed

    Kurokawa, Shun; Ihara, Yasuo

    2009-04-07

    Evolution of cooperation has been a major issue in evolutionary biology. Cooperation is observed not only in dyadic interactions, but also in social interactions involving more than two individuals. It has been argued that direct reciprocity cannot explain the emergence of cooperation in large groups because the basin of attraction for the 'cooperative' equilibrium state shrinks rapidly as the group size increases. However, this argument is based on the analysis of models that consider the deterministic process. More recently, stochastic models of two-player games have been developed and the conditions for natural selection to favour the emergence of cooperation in finite populations have been specified. These conditions have been given as a mathematically simple expression, which is called the one-third law. In this paper, we investigate a stochastic model of n-player games and show that natural selection can favour a reciprocator replacing a population of defectors in the n-player repeated Prisoner's Dilemma game. We also derive a generalized version of the one-third law (the {2/[n(n+1)]}1/(n-1) law). Additionally, contrary to previous studies, the model suggests that the evolution of cooperation in public goods game can be facilitated by larger group size under certain conditions.

  8. A transatlantic comparison of training in emergency medicine.

    PubMed Central

    Wyatt, J P; Weber, J E

    1998-01-01

    The system of training in accident and emergency (A&E) medicine in the United Kingdom is at a critical and much earlier stage of development than in the United States. Transatlantic comparison offers the opportunity to explore possible ways of improving training in the United Kingdom. Comparison revealed deficiencies in the UK training system in the following: prehospital care training, formal theoretical teaching, close supervision in a clinical setting, and in-service training examinations. Implementation of measures designed to address these deficiencies would enhance UK training in A&E medicine. PMID:9639180

  9. Emergency medicine and its development in Ethiopia with emphasis on the role of Addis Ababa University, School of Medicine, Emergency Medicine Department.

    PubMed

    Azazh, Aklilu; Teklu, Sisay; Woldetsadi, Assefu; Seyoum, Nebyou; Geremew, Haimanot; Busse, Heidi; Tefera, Girma; Wubben, Ryan; Rankin, Pete; Tupesis, Janis P; Maskalyk, James; Landes, Megan; Mehari, Enawgaw; Derbew, Milliard

    2014-07-01

    Globally Emergency Medicine (EM) is young discipline and even in developed countries it is about five decades old. In Ethiopia formal pre-hospital care or hospital based Emergency department (ED) development is a recent phenomenon and this article describes development of Emergency Medicine care in Ethiopia before, around and after Ethiopia millennium. Documents related to emergency medicine development and implementation from different government and nongovernmental data sources are used as a resource for this article. Emergency Medicine task force (EMTF) has been established in Addis Ababa University (AAU) school of Medicine (SOM) in June 2006 and the taskforce has closely worked with Federal Ministry of Health (FMOH) and Addis Ababa city council Health Bureau (AACCHB). In addition to the main actors many partners have contributed significantly to this initiative. Some of the developments were establishment of emergency departments in Tikur Anbessa Specialized Hospital (TASH) and the restructuring of EM service by FMOH. Emergency care has been considered as a crucial service in hospitals' service along with outpatient and inpatient services. Furthermore, Pre-hospital care initiatives have been commenced in Addis Ababa and expanded to the regions with a arrangement of one or two ambulances to small districts having 100,000 population. There have also been key achievement in human resource development, notably the establishment of EM residency and MSC in EM and critical care nursing. Prehospital care givers training programs in order to produce emergency medicine technicians (EMT) have been started in various regional health professionals training centers. Furthermore, EM module has been included in the current undergraduate medical education. The Ethiopian society of emergency professionals (ESEP) has been established with members from different categories of emergency medicine professionals. In all these developments the emergency medicine training center in the

  10. How can departments of community medicine shape the future of public health education in India?

    PubMed

    Negandhi, Himanshu; Sharma, Kavya; Zodpey, Sanjay P

    2010-01-01

    In order to effectively respond to a changing public health paradigm, it is imperative that the medical education and overall public health education (PHE) parallel the public health challenges faced by countries. Community medicine departments play a crucial role in PHE. This review analyzes the current situation of community medicine departments in the context of PHE, using a framework that outlines academic activities undertaken by these departments. This framework includes the syllabus of academic programs, internship, and infrastructure and faculty strength in the community medicine departments. The review also discusses how skill building of existing faculty members can help us in addressing emerging public health issues, and the role of partnerships and collaborative activities in advancing the PHE agenda, thereby continuing to shape the role played by these departments toward shaping the future of PHE in India.

  11. [Social medicine, public health and governance for health].

    PubMed

    Holčík, Jan

    Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

  12. Biodiversity, traditional medicine and public health: where do they meet?

    PubMed Central

    2007-01-01

    Given the increased use of traditional medicines, possibilities that would ensure its successful integration into a public health framework should be explored. This paper discusses some of the links between biodiversity and traditional medicine, and addresses their implications to public health. We explore the importance of biodiversity and ecosystem services to global and human health, the risks which human impacts on ecosystems and biodiversity present to human health and welfare. PMID:17376227

  13. Infant Trauma Management in the Emergency Department: An Emergency Medicine Simulation Exercise

    PubMed Central

    Mathieson, Sarah; Whalen, Desmond

    2015-01-01

    In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. In the case of infant trauma, sensitivities have to be taken that are specific to pediatric medicine. The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents. PMID:26487992

  14. Post-war development of emergency medicine in Kosovo.

    PubMed

    O'Hanlon, K P; Lerner, E B

    2007-01-01

    To (1) investigate emergency medical care priorities in Kosovo, (2) assess Kosovo's post-war development of emergency medical services and (3) identify expectations. An instrument with seven open-ended questions, approved by the institutional review board, was designed for in-person interviews (preferred) or written survey. The survey was administered in October 2003 at the Kosovo University Clinical Center, Pristina, Kosovo, and one regional hospital. Targeted participants were emergency care providers, clinical consultants and health policy consultants. Surveys were conducted by interview with simultaneous interpretation by a native Albanian speaker, an orthopaedic surgeon or in written Albanian form. The responses were evaluated quantitatively and qualitatively. 13 respondents participated in the study: 10 gave interviews and 3 provided written response; 7 were emergency care providers, 4 were emergency care consultants and 2 were health policy consultants. Emergency care priorities were defined as trauma, cardiac disease and suicide. Most respondents believed that emergency medicine as a specialised field was a post-war development. The international community was credited with the provision of infrastructure, supplies and training. Most respondents denied any harm from international assistance. However, some respondents described instances of inappropriate international investment. Ongoing needs are training of providers and equipping of facilities and vehicles. Improved hospital management, political administration and international involvement are thought to be necessary for continued development. Survey respondents agreed on priorities in emergency care, credited the international community with development to date, and identified administrative structures and international training support as the keys to ongoing development.

  15. Point-of-care ultrasonography by pediatric emergency medicine physicians.

    PubMed

    Marin, Jennifer R; Lewiss, Resa E

    2015-04-01

    Emergency physicians have used point-of-care ultrasonography since the 1990 s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing quality assurance reviews.

  16. Toward a definition of teamwork in emergency medicine.

    PubMed

    Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

    2008-11-01

    The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.

  17. Academic career development for emergency medicine residents: a road map.

    PubMed

    Stead, Latha G; Sadosty, Annie T; Decker, Wyatt W

    2005-05-01

    As the marketplace for academic positions in emergency medicine grows more competitive, it becomes increasingly important for residents who desire academic careers to distinguish themselves during their residency. This report attempts to outline a road map for department and residency program leaders to help their houseofficers become successful candidates for an academic emergency medicine position. Specific ways a resident can enhance his or her "academic marketability" include 1) involvement in research, 2) establishment of a track record of productivity via scholarly writing, 3) awareness of the literature in the specialty, 4) involvement in specialty organizations and hospital committees, 5) competition for national awards, 6) gaining education skills, 7) developing an academic niche, and 8) fellowship training.

  18. Development of an International Elective in an Emergency Medicine Residency.

    PubMed

    Hayden, Stephen R; Valderrama, Chad M; Xu, Marian; Curran, Maureen A; Mazondo, Roberto; Soliman, Mounir A

    2016-01-01

    There is a continued interest in global emergency medicine (EM) training, research, and clinical program development. There are many opportunities for "voluntourism" in medicine, but many of these experiences do not have standard goals and objectives. This article describes a rotation for EM residents from the United States to have a structured learning experience focusing on emergency medical settings in the prehospital phase (something often lacking in U.S. programs). The authors discuss the structure of the training program, including goals, objectives, and core competencies. First-hand accounts of the training experience are also presented. Global training experiences can have clear benefits. Students go to places to "learn," but can also "teach" at the same time. Setting goals and objectives helps to assure that students are gaining specific core competencies as part of the experience. Other global rotations would benefit from having a defined structure. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Emergency medicine in Argentina: a stepwise process to specialty recognition.

    PubMed

    Godoy Monzón, Daniel; Peralta, Hugo; Iserson, Kenneth V

    2010-04-01

    As emergency medicine (EM) has developed as a medical specialty throughout the world, each country has followed its own path to official recognition. Despite a successful EM model in the United States, some countries, especially those that require government approval of new medical specialties, have often found it difficult to attain recognition. As of early 2009, Argentina had yet to recognize EM as an official specialty, although some regional governments have acknowledged the specialty's status. The Argentine Society of EM has taken a number of steps and proposed educational paths to EM specialization to convince Argentina's political decision-makers that Emergency Medicine is a fundamental step toward a modern medical system. Such national recognition would further an already thriving EM community and improve the quality of patient care in Argentina. To assist colleagues around the world who are pursuing or will pursue this goal, this article outlines Argentina's complex and ongoing path to specialty recognition. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Intern underperformance is detected more frequently in emergency medicine rotations.

    PubMed

    Aram, Narelle; Brazil, Victoria; Davin, Lorna; Greenslade, Jaimi

    2013-02-01

    To determine the frequency and nature of intern underperformance as documented on in-training assessment forms. A retrospective review of intern assessment forms from a 2 year period (2009-2010) was conducted at a tertiary referral hospital in Brisbane, Queensland. The frequency of interns assessed as 'requiring substantial assistance' and/or 'requires further development' on mid- or end-of-term assessment forms was determined. Forms were analysed by the clinical rotation, time of year and domain(s) of clinical practice in which underperformance was documented. During 2009 and 2010 the overall documented incidence of intern underperformance was 2.4% (95% CI 1.5-3.9%). Clinical rotation in emergency medicine detected significantly more underperformance compared with other rotations (P < 0.01). Interns predominantly had difficulty with 'clinical judgment and decision-making skills', 'time management skills' and 'teamwork and colleagues' (62.5%, 55% and 32.5% of underperforming assessments, respectively). Time of the year did not affect frequency of underperformance. A proportion of 13.4% (95% CI 9.2-19.0%) of interns working at the institution over the study period received at least one assessment in which underperformance was documented. Seventy-six per cent of those interns who had underperformance identified by mid-term assessment successfully completed the term following remediation. The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Interprofessional education of medical students and paramedics in emergency medicine.

    PubMed

    Hallikainen, J; Väisänen, O; Rosenberg, P H; Silfvast, T; Niemi-Murola, L

    2007-03-01

    Emergency medicine is team work from the field to the hospital and therefore it is also important for physicians to understand the work of paramedics, and vice versa. Interprofessional emergency medicine education for medical and paramedic students in Helsinki was started in 2001. It consisted of a 15 European credit transfer system (ECTS) credits programme combining 22 students in 2001. In 2005, the number of students had increased to 25. The programme consisted of three parts: acute illness in childhood and adults (AI), advanced life support (ALS) and trauma life support (TLS). In this paper, we describe the concept of interprofessional education of medical students and paramedics in emergency medicine. After finishing the programmes in 2001 and in 2005, the students' opinions regarding the education were collected using a standardized questionnaire. There were good ratings for the courses in AI (2001 vs. 2005, whole group; 4.3 +/- 0.7 vs. 4.2 +/- 0.4, P = 0.44) ALS (4.7 +/- 0.5 vs. 4.4 +/- 0.5, P = 0.06) and TLS (3.9 +/- 0.7 vs. 4.4 +/- 0.5, P = 0.01) in both years. Most of the medical students considered that this kind of co-education should be arranged for all medical students (2001 vs. 2005; 4.8 +/- 0.6 vs. 4.4 +/- 0.5, P = 0.02) and should be obligatory (3.5 +/- 1.5 vs. 3.1 +/- 1.3, P = 0.35). Co-education was well received and determined by the students as an effective way of improving their knowledge of emergency medicine and medical skills. The programme was rated as very useful and it should be included in the educational curriculum of both student groups.

  2. Citizens' perspectives on personalized medicine: a qualitative public deliberation study.

    PubMed

    Bombard, Yvonne; Abelson, Julia; Simeonov, Dorina; Gauvin, Francois-Pierre

    2013-11-01

    Our objective was to explore citizens' informed and reasoned values and expectations of personalized medicine, a timely yet novel genomics policy issue. A qualitative, public deliberation study was undertaken using a citizens' reference panel on health technologies, established to provide input to the health technology assessment process in Ontario, Canada. The citizens' panel consisted of five women and nine men, aged 18-71 years, with one member selected from each health authority region. There were shared expectations among the citizens' panel members for the potential of personalized medicine technologies to improve care, provided they are deemed clinically valid and effective. These expectations were tempered by concerns about value for money and the possibility that access to treatment may be limited by personalized medicine tests used to stratify patients. Although they questioned the presumed technological imperative presented by personalized medicine technologies, they called for increased efforts to prepare the health-care system to effectively integrate these technologies. This study represents an early but important effort to explore public values toward personalized medicine. This study also provides evidence of the public's ability to form coherent judgments about a new policy issue. Concerned that personalized tests might be used to ration care, they suggested that treatment should be made available if patients wanted it, irrespective of tests that indicate little benefit. This issue raises clinical and policy challenges that may undermine the value of personalized medicine. Further efforts to deliberate with the public are warranted to inform effective, efficient and equitable translation of personalized medicine.

  3. Affective temperament and executive functions in emergency medicine professionals.

    PubMed

    Jaracz, Marcin; Paciorek, Przemysław; Buciński, Adam; Borkowska, Alina

    2014-10-01

    Recent studies indicate that choice of profession is related to differences in affective temperament, which is probably due to various predispositions needed to efficiently perform particular professions. The aim of the present study was to assess affective temperament and executive functions in a sample of emergency medicine professionals. 75 emergency medicine professionals were enrolled in the study. Affective temperament was assessed by means of TEMPS-A. Executive functions were assessed by means of Trail Making Test and Stroop Color Word Interference Test. Subjects showed significantly higher rates of hyperthymic, compared to depressive, cyclothymic, irritable and anxious temperaments. The principal component analysis revealed that hyperthymic temperament contributes to a different factor, than the remaining ones. Higher rates of depressive, cyclothymic, irritable and anxious temperaments were related to poorer performance in Trail Making Test, whereas hyperthymic temperament had the opposite effect. Due to the size of the sample, results of the present study may have lacked power to show all the relationships between tested variables. Hyperthymic temperament promotes efficient performance of complex tasks under time pressure. Depressive, cyclothymic, irritable and anxious temperaments have the opposite effect. This makes hyperthymic temperament a desirable trait in emergency medicine professionals, performing complex medical tasks under extreme conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. The International Federation for Emergency Medicine framework for quality and safety in the emergency department.

    PubMed

    Lecky, Fiona; Benger, Jonathan; Mason, Suzanne; Cameron, Peter; Walsh, Chris

    2014-11-01

    All emergency departments (EDs) have an obligation to deliver care that is demonstrably safe and of the highest possible quality. Emergency medicine is a unique and rapidly developing specialty, which forms the hub of the emergency care system and strives to provide a consistent and effective service 24 h a day, 7 days a week. The International Federation of Emergency Medicine, representing more than 70 countries, has prepared a document to define a framework for quality and safety in the ED. Following a consensus conference and with subsequent development, a series of quality indicators have been proposed. These are tabulated in the form of measures designed to answer nine quality questions presented according to the domains of structure, process and outcome. There is an urgent need to improve the evidence base to determine which quality indicators have the potential to successfully improve clinical outcomes, staff and patient experience in a cost-efficient manner--with lessons for implementation.

  5. Pediatric emergency research networks: a global initiative in pediatric emergency medicine.

    PubMed

    Klassen, Terry P; Acworth, Jason; Bialy, Liza; Black, Karen; Chamberlain, James M; Cheng, Nicholas; Dalziel, Stuart; Fernandes, Ricardo M; Fitzpatrick, Eleanor; Johnson, David W; Kuppermann, Nathan; Macias, Charles G; Newton, Mandi; Osmond, Martin H; Plint, Amy; Valerio, Paolo; Waisman, Yehezkel

    2010-08-01

    Objectives of the Pediatric Emergency Research Network's (PERN's) meeting included (1) learn about each of the participating network's missions, goals, and infrastructure; (2) share important contributions each network has made to the creation of new knowledge; (3) discuss "best practices" to improve each network's effectiveness; and (4) explore the potential for a collaborative research project as proof of concept that would help us promote quality of care of the acutely ill and injured child/youth globally. In October 2009, a multiday meeting was attended by 18 delegates representing the following pediatric emergency medicine research networks: Pediatric Emergency Medicine Collaborative Research Committee (United States), Pediatric Emergency Care Applied Research Network (United States), Pediatric Emergency Research of Canada (Canada), Paediatric Research in Emergency Departments International Collaborative (Australia and New Zealand), and Research in European Pediatric Emergency Medicine (15 countries in Europe and the Middle East). The inaugural meeting of PERN demonstrated that there is a common desire for high-quality research and the dissemination of this research to improve health and outcomes of acutely ill and injured children and youths throughout the world. Presently, the PERN group is in the final stages of developing a protocol to assess H1N1 risk factors with the collection of retrospective data. Several members of PERN will be gathering at the International Conference on Emergency Medicine in Singapore, where the group will be presenting information about the H1N1 initiative. The PERN group is planning to bring together all 5 networks later in 2010 to discuss future global collaborations.

  6. Pediatric Emergency Research Networks: a global initiative in pediatric emergency medicine.

    PubMed

    Klassen, Terry P; Acworth, Jason; Bialy, Liza; Black, Karen; Chamberlain, James M; Cheng, Nicholas; Dalziel, Stuart; Fernandes, Ricardo M; Fitzpatrick, Eleanor; Johnson, David W; Kuppermann, Nathan; Macias, Charles G; Newton, Mandi; Osmond, Martin H; Plint, Amy; Valerio, Paolo; Waisman, Yehezkel

    2010-08-01

    The objectives of the Pediatric Emergency Research Network's (PERN) meeting were to (i) learn about each of the participating network's missions, goals, and infrastructure; (ii) share important contributions that each network has made to the creation of new knowledge; (iii) discuss 'best practices' to improve each network's effectiveness and (iv) explore the potential for a collaborative research project as proof-of-concept that would help promote quality of care of the acutely ill and injured child/youth globally. In October 2009 a multiday meeting was attended by 18 delegates representing the following pediatric emergency medicine research networks: Pediatric Emergency Medicine Collaborative Research Committee (USA); Pediatric Emergency Care Applied Research Network (USA); Pediatric Emergency Research of Canada (Canada); Pediatric Research in Emergency Departments International Collaborative (Australia and New Zealand); and Research in European Pediatric Emergency Medicine (15 countries in Europe and the Middle East). The inaugural meeting of PERN showed that there is a common desire for high-quality research and the dissemination of this research to improve health and outcomes of acutely ill and injured children and youths throughout the world. At present, the PERN group is in the final stages of developing a protocol to assess H1N1 risk factors with the collection of retrospective data. Several members of PERN will be gathering at the International Conference on Emergency Medicine in Singapore, where the group will be presenting information about the H1N1 initiative. The PERN group is planning to bring together all five networks later in 2010 to discuss future global collaborations.

  7. Obstetric training in Emergency Medicine: a needs assessment.

    PubMed

    Janicki, Adam James; MacKuen, Courteney; Hauspurg, Alisse; Cohn, Jamieson

    2016-01-01

    Identification and management of obstetric emergencies is essential in emergency medicine (EM), but exposure to pregnant patients during EM residency training is frequently limited. To date, there is little data describing effective ways to teach residents this material. Current guidelines require completion of 2 weeks of obstetrics or 10 vaginal deliveries, but it is unclear whether this instills competency. We created a 15-item survey evaluating resident confidence and knowledge related to obstetric emergencies. To assess confidence, we asked residents about their exposure and comfort level regarding obstetric emergencies and eight common presentations and procedures. We assessed knowledge via multiple-choice questions addressing common obstetric presentations, pelvic ultrasound image, and cardiotocography interpretation. The survey was distributed to residency programs utilizing the Council of Emergency Medicine Residency Directors (CORD) listserv. The survey was completed by 212 residents, representing 55 of 204 (27%) programs belonging to CORD and 11.2% of 1,896 eligible residents. Fifty-six percent felt they had adequate exposure to obstetric emergencies. The overall comfort level was 2.99 (1-5 scale) and comfort levels of specific presentations and procedures ranged from 2.58 to 3.97; all increased moderately with postgraduate year (PGY) level. Mean overall percentage of items answered correctly on the multiple-choice questions was 58% with no statistical difference by PGY level. Performance on individual questions did not differ by PGY level. The identification and management of obstetric emergencies is the cornerstone of EM. We found preliminary evidence of a concerning lack of resident comfort regarding obstetric conditions and knowledge deficits on core obstetrics topics. EM residents may benefit from educational interventions to increase exposure to these topics.

  8. A Prospective Evaluation of Transverse Tracheal Sonography During Emergent Intubation by Emergency Medicine Resident Physicians.

    PubMed

    Lahham, Shadi; Baydoun, Jamie; Bailey, James; Sandoval, Sandra; Wilson, Sean P; Fox, John C; Slattery, David E

    2017-10-01

    Establishing a definitive airway is often the first step in emergency department treatment of critically ill patients. Currently, there is no agreed upon consensus as to the most efficacious method of airway confirmation. Our objective was to determine the diagnostic accuracy of real-time sonography performed by resident physicians to confirm placement of the endotracheal tube during emergent intubation. We performed a prospective cohort study of adult patients in the emergency department undergoing emergent endotracheal intubation. Thirty emergency medicine residents, who were blinded to end-tidal carbon dioxide detection results, performed real-time transverse tracheal sonography during intubation to evaluate correct endotracheal tube placement. Seventy-two patients were enrolled in the study. Sixty-eight instances (94.4%) were interpreted as correct placement in the trachea; 4 (5.6%) were interpreted as esophageal, of which 1 was a false-negative finding, therefore conferring sensitivity of 98.5% (95% confidence interval, 92.1%-99.9%) and specificity of 75.0% (95% confidence interval, 19.4%-99.4%) for correct placement. There was no significant difference in accuracy among resident sonographers with different levels of residency training. A simple transverse tracheal sonographic examination performed by emergency medicine resident physicians can be used as an adjunct to help confirm correct endotracheal tube placement during intubation. In our cohort, the level of training did not appear to affect the ability of residents to correctly identify the endotracheal tube position. © 2017 by the American Institute of Ultrasound in Medicine.

  9. Global emergency medicine journal club: social media responses to the January 2014 online emergency medicine journal club on subarachnoid hemorrhage.

    PubMed

    Chan, Teresa M; Rosenberg, Hans; Lin, Michelle

    2014-07-01

    From January 20 to 24, 2014, Annals continued a successful collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host another Global Emergency Medicine Journal Club session featuring the 2013 Journal of the American Medical Association article "Clinical Decision Rules to Rule Out Subarachnoid Hemorrhage for Acute Headache" by Perry et al. This online journal club used the power of rapid Twitter conversations, a live videocast with the authors, and more detailed discussions hosted on the ALiEM Web site's comment section. There were more than 1,431 individuals from 501 cities in 59 countries who viewed the blog post. During this 5-day event, 28 comments (average word count 153 words) and 206 tweets were made. This summary article details the community discussion, shared insights, and analytic data generated during this novel, multiplatform approach.

  10. Celebrating Leadership in Public Health and Medicine

    MedlinePlus

    ... memory of FNLM's long-time chairman, the Honorable Paul G. Rogers, a member of Congress for 22 ... populations in the Rio Grande Valley. 4 The Paul G. Rogers Public Service Award was presented to ...

  11. Refining the Enrolment Process in Emergency Medicine Research

    PubMed Central

    Sahan, Kate M; Channon, Keith M; Choudhury, Robin P; Kharbanda, Rajesh K; Lee, Regent; Sheehan, Mark

    2016-01-01

    Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient’s lack of mental capacity and insufficient time to contact legal representatives. Regulatory frameworks which allow this research to proceed with a consent ‘waiver’, provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the ‘emergent’ stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed. PMID:27499840

  12. The use of reflection in emergency medicine education.

    PubMed

    Bernard, Aaron W; Gorgas, Diane; Greenberger, Sarah; Jacques, Andrew; Khandelwal, Sorabh

    2012-08-01

    Reflection is a cognitive process in which new information and experiences are integrated into existing knowledge structures and mental models, resulting in meaningful learning. Reflection often occurs after an experience is over, promoting professional development and lifelong learning. However, a reflective emergency physician (EP) is also able to apply reflection in real time: self-monitoring, coping with the unexpected, and quickly thinking on his or her feet to solve complicated, unique, and challenging clinical problems. Reflection is a skill that can be taught and developed in medical education. Evidence demonstrating the value of teaching reflection is emerging that substantiates longstanding educational theories. While a few educators have started to explore the use of reflection for emergency medicine (EM) learners, the potential for broader application exists. This review summarizes the literature regarding reflection in medical education and provides a basic primer for teaching reflection.

  13. Time-Driven Activity-Based Costing in Emergency Medicine.

    PubMed

    Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S

    2016-06-01

    Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  14. Globalizing the history of disease, medicine, and public health in Latin America.

    PubMed

    Espinosa, Mariola

    2013-12-01

    The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness to transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health.

  15. Best educational practices in pediatric emergency medicine during emergency medicine residency training: guiding principles and expert recommendations.

    PubMed

    Cloutier, Robert L; Walthall, Jennifer D H; Mull, Colette C; Nypaver, Michele M; Baren, Jill M

    2010-10-01

    The state of pediatric emergency medicine (PEM) education within emergency medicine (EM) residency programs is reviewed and discussed in the context of shifting practice environments and new demands for a greater focus on the availability and quality of PEM services. The rapid growth of PEM within pediatrics has altered the EM practice landscape with regard to PEM. The authors evaluate the composition, quantity, and quality of PEM training in EM residency programs, with close attention paid to the challenges facing programs. A set of best practices is presented as a framework for discussion of future PEM training that would increase the yield and relevance of knowledge and experiences within the constraints of 3- and 4-year residencies. Innovative educational modalities are discussed, as well as the role of simulation and pediatric-specific patient safety education. Finally, barriers to PEM fellowship training among EM residency graduates are discussed in light of the shortage of practitioners from this training pathway and in recognition of the ongoing importance of the EM voice in PEM. © 2010 by the Society for Academic Emergency Medicine.

  16. Emergency medicine and air rescue in India: future perspectives.

    PubMed

    Sachdev, K S

    2000-01-26

    76.7% of Indian population lives in rural areas. About 160,000 primary health care centres and subcentres, established all over the country, are responsible for the emergency care in the countryside. A centre, manned by a qualified doctor, a nurse/midwife and paramedics, with basic equipment and facilities has to manage all types of medical emergencies in a population of 3000 - 5000. A patient who survives this emergency care has to be transferred to higher secondary / tertiary centre. In metropolitan areas there are larger hospitals some of them having well equipped casualty departments supervised by specialists, but the number of patients are so large that the management of emergency goes often haywire. Patient transport system is very inadequate. The ambulances are scarce and mostly not well equipped. Air rescue which is the most desired, because of the distances and road conditions, is only in a rudimentary state. Existing infrastructure more than 400 airports, airstrips and many helipads, well qualified flying personnel and well maintained small and large aircrafts is sufficient to have a well functioning Air Rescue system. But it is prohibitively expensive. Most individuals are neither able to afford Air Rescue on their own cost nor they are insured. With the growth of economy and ever increasing awareness of medical facilities, the demand of better standards of emergency medicine is going up. In next 20 years a different scenario is expected. Availability of information technology, privatization of insurance system and medical facilities and better transport system and roads in the coming years will facilitate a well functioning emergency medicine and air rescue in India.

  17. Global Emergency Medicine: A Review of the Literature From 2015.

    PubMed

    Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Bisanzo, Mark; Jacquet, Gabrielle A; Lunney, Kevin; Marsh, Regan; Osei-Ampofo, Maxwell; Trehan, Indi; Lam, Christopher; Levine, Adam C

    2016-10-01

    The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year 12,435 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 723 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 723 articles met our predetermined inclusion criteria and underwent full review. Sixty percent were categorized as emergency care in resource-limited settings (ECRLS), 17% as EM development (EMD), and 23% as disaster and humanitarian response (DHR). Twenty-four articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability between reviewers gave an intraclass correlation coefficient of 0.71 (95% confidence interval = 0.66 to 0.75). Studies and reviews with a focus on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review. In 2015, there were almost twice as many articles found by our search compared to the 2014 review. The number of EMD articles increased, while the number ECRLS articles decreased. The number of DHR articles remained stable. As in prior years, the majority of articles focused on infectious diseases. © 2016 by the Society for Academic Emergency Medicine.

  18. Public health in the emergency department: surveillance, screening, and intervention--funding and sustainability.

    PubMed

    Woolard, Robert; Degutis, Linda C; Mello, Michael; Rothman, Richard; Cherpitel, Cheryl J; Post, Lori A; Hirshon, Jon Mark; Haukoos, Jason S; Hungerford, Daniel W

    2009-11-01

    This article summarizes the work and discussions of the funding and sustainability work group at the 2009 Academic Emergency Medicine consensus conference "Public Health in the ED: Surveillance, Screening, and Intervention." The funding and sustainability session participants were asked to address the following overarching question: "What are the opportunities and what is needed to encourage academic emergency medicine (EM) to take advantage of the opportunities for funding available for public health research initiatives and build stronger academic programs focusing on public health within EM?" Prior to the session, members of the group reviewed research funding for EM in public health, as well as the priorities of federal agencies and foundations. Recommendations for actions by EM summarize the findings of workshop.

  19. Current and emerging applications of 3D printing in medicine.

    PubMed

    Liaw, Chya-Yan; Guvendiren, Murat

    2017-06-07

    Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.

  20. Demography and Public Health Emergency Preparedness: Making the Connection

    PubMed Central

    Katz, Rebecca

    2009-01-01

    The tools and techniques of population sciences are extremely relevant to the discipline of public health emergency preparedness: protecting and securing the population’s health requires information about that population. While related fields such as security studies have successfully integrated demographic tools into their research and literature, the theoretical and practical connection between the methods of demography and the practice of public health emergency preparedness is weak. This article suggests the need to further the interdisciplinary use of demography by examining the need for a systematic use of population science techniques in public health emergency preparedness. Ultimately, we demonstrate how public health emergency preparedness can incorporate demography to develop more effective preparedness plans. Important policy implications emerge: demographers and preparedness experts need to collaborate more formally in order to facilitate community resilience and mitigate the consequences of public health emergencies. PMID:20694030

  1. Leptospirosis: an emerging global public health problem.

    PubMed

    Vijayachari, P; Sugunan, A P; Shriram, A N

    2008-11-01

    Leptospirosis has been recognized as an emerging global public health problem because of its increasing incidence in both developing and developed countries.A number of leptospirosis outbreaks have occurred in the past few years in various places such as Nicaragua, Brazil and India.Some of these resulted due to natural calamities such as cyclone and floods. It is a direct zoonotic disease caused by spirochetes belonging to different pathogenic species of the genus Leptospira. Large number of animals acts as carriers or vectors.Human infection results from accidental contact with carrier animals or environment contaminated with leptospires. The primary source of leptospires is the excretor animal, from whose renal tubules leptospires are excreted into the environment with the animal urine. Majority of leptospiral infections are either sub clinical or result in very mild illness and recover without any complications.However,a small proportion develops various complications due to involvement of multiple organ systems. In such patients, the clinical presentation depends upon the predominant organs involved and the case fatality ratio could be about 40% or more. Febrile illness with icterus, splenomegaly and nephritis (known as Weil's disease), acute febrile illness with severe muscle pain,febrile illness with pulmonary haemorrhages in the form of haemoptysis, jaundice with pulmonary haemorrhages, jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic principles of prevention such as source reduction,environmental sanitation, more hygienic work-related and personal practices etc., are same everywhere, there is no universal control method applicable to all epidemiological settings. Comprehensive understanding of the

  2. Human rights, public health and medicinal cannabis use

    PubMed Central

    Bone, Melissa; Seddon, Toby

    2016-01-01

    This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of ‘health’. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary’s failure to engage with an individual’s human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health. PMID:26692654

  3. Human rights, public health and medicinal cannabis use.

    PubMed

    Bone, Melissa; Seddon, Toby

    2016-01-01

    This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of 'health'. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary's failure to engage with an individual's human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health.

  4. Evolution of the Model of the Clinical Practice of Emergency Medicine: 1979 to Present.

    PubMed

    Counselman, Francis L; Beeson, Michael S; Marco, Catherine A; Adsit, Susan K; Harvey, Anne L; Keehbauch, Julia N

    2017-02-01

    The Model of the Clinical Practice of Emergency Medicine (the EM Model) is a three-dimensional representation of the clinical practice of emergency medicine. It is a product of successful collaboration involving the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the Society for Academic Emergency Medicine (SAEM), the Emergency Medicine Residents' Association (EMRA), the Council of Emergency Medicine Residency Directors (CORD), the Residency Review Committee for Emergency Medicine (RRC-EM), and the American Academy of Emergency Medicine (AAEM). In 2017, the most recent update and revision of the EM Model will be published. This document will represent the culmination of nearly 40 years of evolution, from a simple listing of presenting patient complaints, clinical symptoms, and disease states into a three-dimensional representation of the clinical practice of emergency medicine. These dimensions include conditions and components, physician tasks, and patient acuity. In addition, over the years, two other documents have been developed, the Knowledge, Skills, and Abilities (KSAs) and the Emergency Medicine Milestones. Both serve as related and complementary educational and assessment tools. This article will review the development of the EM Model from its inception in 1979 to today. © 2016 by the Society for Academic Emergency Medicine.

  5. The emergence of trust in clinics of alternative medicine.

    PubMed

    Pedersen, Inge Kryger; Hansen, Vibeke Holm; Grünenberg, Kristina

    2016-01-01

    Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives.

  6. Public health and precision medicine share a goal.

    PubMed

    Vaithinathan, Asokan G; Asokan, Vanitha

    2016-12-16

    The advances made in genomics and molecular tools aid public health programs in the investigation of outbreaks and control of diseases by taking advantage of the precision medicine. Precision medicine means "segregating the individuals into subpopulations who vary in their disease susceptibility and response to a precise treatment" and not merely designing of drugs or creation of medical devices. By 2017, the United Kingdom 100,000 Genomes Project is expected to sequence 100,000 genomes from 70,000 patients. Similarly, the Precision Medicine Initiative of the United States plans to increase population-based genome sequencing and link it with clinical data. A national cohort of around 1 million people is to be established in the long term, to investigate the genetic and environmental determinants of health and disease, and further integrated to their electronic health records that are optional. Precision public health can be seen as administering the right intervention to the needy population at an appropriate time. Precision medicine originates from a wet-lab while evidence based medicine is nurtured in a clinic. Linking the quintessential basic science research and clinical practice is necessary. In addition, new technologies to employ and analyze data in an integrated and dynamic way are essential for public health and precision medicine. The transition from evidence-based approach in public health to genomic approach to individuals with a paradigm shift of a "reactive" medicine to a more "proactive" and personalized health care may sound exceptional. However, a population perspective is needed for the precision medicine to succeed. This article is protected by copyright. All rights reserved.

  7. [New Royal Decree on clinical trials: main implications for emergency medicine physicians who do research].

    PubMed

    García Arenillas, Mar; Haj-Ali Saflo, Okba; Sáenz de Tejada, Marta

    2017-06-01

    The new European Union directives affecting clinical trials of medicines introduced important changes for Spain, leading to the publication of a Royal Decree regulating the conduct of clinical trials that went into effect in January 2016. The decree sets out the principles for complying with the EU directives, regulates the work of institutional review boards (IRBs) or ethics committees that review research proposals, introduces means to facilitate clinical research, and clarifies the role of the Spanish register of clinical trials, among other topics. This paper discusses the main changes that have been introduced, especially those intended to facilitate research, such as the new concepts of low intervention trial and noncommercial clinical research. These concepts may be particularly useful for clinical trials designed by emergency medicine physicians. We also comment on changes affecting vulnerable populations and the documents that must be presented to both the researchers' IRB and the Spanish Agency for Medicines and Health Care Products.

  8. Implementation of a hypertext-based curriculum for emergency medicine on the World Wide Web.

    PubMed

    Savitt, D L; Steele, D W

    1997-12-01

    This project reports the publication of a variety of existing curricular resources for emergency medicine on the global Internet in a format that allows hypertext links between related material, timely updates, and end-user feedback. Curricular elements were converted to Hypertext Markup Language with extensive links between related content. The completed document contains instructions for curriculum development, specific curricula for subspecialty areas within a residency, reading lists for subspecialty curricula, banks of images, and board-type questions with answers. Users are provided with a mechanism to provide immediate feedback to section editors with suggestions for changes, including new references. Access to all or part of the document can be controlled via passwords, but is potentially available to anyone with an Internet connection and a World Wide Web browser. The document may by viewed on the World Wide Web at: http:@www.brown.edu@Administration@emergency_Medicine@ curr.html.

  9. Ebola Virus Preparedness: Emerging Viruses and Ethics in Laboratory Medicine.

    PubMed

    Dubov, Alex; Appleton, Julia H; Campbell, Sheldon

    2016-02-01

    Emerging pathogens have affected, and will continue to affect, the health care system in diverse ways. Clinical laboratories face ethical challenges in responding to emerging pathogens. We use the 2014-2015 outbreak of Ebola virus disease as a model to explore some of the ethical issues in laboratory medicine related to emerging infectious disease. To describe the major ethical concerns raised in the clinical laboratory environment by emerging infections. We assessed current guidelines and practices in the Ebola outbreak in developed-world clinical laboratories, reviewed risk assessment practices and the role of the clinical laboratory in providing care for patients with potential or confirmed Ebola, and reviewed the relevant literature on duty to provide care in the laboratory context. Clinical laboratories in developed countries have to rely more on expert guidelines and theoretical risk assessments than on practice in less-developed areas. Risk minimization for clinical laboratory workers is essential but may conflict with the laboratory's duty to provide standard of care. Patients can be put at risk not only from loss of laboratory services from restriction of testing but also from impairment of laboratory services in cases of spills or accidents. Significant discrepancies in guidelines from professional and governmental sources exacerbate the difficulty and confusion inherent in dealing with a dynamic, emerging infectious disease crisis. The duty to provide care for laboratory workers is ill-defined. Balancing risks to patients and laboratory workers and benefits to patients presents challenges to laboratory professionals at all levels.

  10. Medicines management in the Philippine public sector during the response to Haiyan

    PubMed Central

    Robles, Yolanda; Loquias, Monet; Capule, Francis; Guerrero, Anna Melissa

    2015-01-01

    Introduction Health service delivery in the Philippines is constantly challenged by disasters and emergencies. This descriptive study documented existing policies for medicines management in the Philippines and then assessed these in the public sector response post-Haiyan. Method We used desk a review of existing laws, regulations and related issuances and a series of interviews of key informants from various national and local health agencies. Results We found that while numerous national policies covered critical aspects of medicines management, implementation post-Haiyan was problematic at all levels of the decentralized health-care system. We identified issues of quantification, warehousing, distribution, utilization monitoring and disposal. Donated medicines also added additional burden for storage and disposal, especially for expired and unwanted medicines. Discussion While the process of managing medicines during disasters did not differ greatly from non-emergency situations, the Haiyan experience highlighted the system’s weaknesses. With the current gaps in implementation, as well as the logistical obstacles brought about by disasters, there is a need to have integrated mechanisms for medicines management in the Philippines. This assessment provided an important opportunity to review the medicines management policies at national and local levels. PMID:26767142

  11. [Specialist training of emergency medicine in a secondary care hospital].

    PubMed

    Palomäki, Ari; Naskali, Jarno; Harjola, Veli-Pekka; Alaspää, Ari; Innamaa, Tapio; Rautava, Veli-Pekka

    2014-01-01

    Emergency Medicine (EM) was established as a speciality in Finland in the beginning of 2013. The training period of six years conforms to the principles of the European Curriculum for EM. We present here the first-year training in Kanta-Häme Central Hospital, located in Southern Finland. Training is not only based on "learning by doing". Lunchtime lectures covering a wide variety of topics in EM are an essential part of our weekly education day. This day also offers to the residents small group sessions with abstracts, case reports, focused lectures and ultrasound training. A successful training program of EM is achievable by good collaboration with other specialities.

  12. Dealing with the difficult student in emergency medicine

    PubMed Central

    2011-01-01

    Dealing with a student who is perceived as difficult to work with or teach is inevitable in any academic physician's career. This paper will outline the basic categories of these difficulties pertinent to Emergency Medicine rotations in order to facilitate appropriate identification of problems. Strategies for evaluation and reporting of the difficult student are presented. Remediation, based on the type of difficulty, is addressed. Timeliness of reporting, evaluation, and feedback are invaluable to allow for appropriate assessment of the outcome of the remediation plan. PMID:21714855

  13. Essentials of Pediatric Emergency Medicine Fellowship: Part 6: Program Administration.

    PubMed

    Kim, In K; Zuckerbraun, Noel; Kou, Maybelle; Vu, Tien; Levasseur, Kelly; Yen, Kenneth; Chapman, Jennifer; Doughty, Cara; McAneney, Constance; Zaveri, Pavan; Hsu, Deborah

    2016-10-01

    This article is the sixth in a 7-part series that aims to comprehensively describe the current state and future directions of pediatric emergency medicine (PEM) fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated upon program completion. This article provides a broad overview of administering and supervising a PEM fellowship program. It explores 3 topics: the principles of program administration, committee management, and recommendations for minimum time allocated for PEM fellowship program directors to administer their programs.

  14. Communicating through the arts: lessons for medicine and public health.

    PubMed

    Parker, Ruth M; Labrecque, Cory Andrew; Candler, Sarah G; Newell-Amato, Domenica; Messler, Jordan; Wolf, Michael; Caughman, S Wright; Raggi-Moore, Judy

    2013-01-01

    [Supplemental materials are available for this article. Go to the publisher's online edition of Journal of Health Communication for the following free supplemental resources: a PowerPoint presentation, Communicating Through the Arts: Lessons for Medicine an Public Health, Symposium Proceedings, June 15-21, 2012, and a video, Communicating Through the Arts: Lessons for Medicine and Public Health, 2012 Symposium. The PowerPoint presentation describes the Symposium and includes a gallery of images. The video is a 6-minute documentary featuring guest faculty discussing the Symposium.].

  15. The Institute of Medicine report on emergency medical services for children: thoughts for emergency medical technicians, paramedics, and emergency physicians.

    PubMed

    Cook, R T

    1995-07-01

    The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Children (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.

  16. Emergency Medicine: On the Frontlines of Medical Education Transformation

    PubMed Central

    Holmboe, Eric S.

    2015-01-01

    Emergency medicine (EM) has always been on the frontlines of healthcare in the United States. I experienced this reality first hand as a young general medical officer assigned to an emergency department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site where patients could not be legally denied care. Despite increased insurance coverage for millions of Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes in a recent survey.1 EDs care for patients from across the socioeconomic spectrum suffering from a wide range of clinical conditions. As a result, the ED is still one of few components of the American healthcare system where social justice is enacted on a regular basis. Constant turbulence in the healthcare system, major changes in healthcare delivery, technological advances and shifting demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex environment. PMID:26594269

  17. [The importance of teamwork in emergency medicine training].

    PubMed

    Vermeulen, B; Carron, P-N

    2007-08-15

    The study of dynamics in relation to performing in small groups has increased pedagogic knowledge about teamwork. The successful management of patients with life-threatening pathologies depends highly from a succession of teams with a specific mission as: the call centre 144, Paramedics, the ED, the Operating Theatre and the Intensive care. To enable each team to operate successfully, it is essential to coordinate their qualifications and synergism. This can be efficiently attained by simulating real situations and by following protocols dedicated to teamwork. Emergency Medicine, which is on the brink of acquiring its proper curriculum, must adopt this concept to integrate knowledge and know-how, and the art of being and doing. At this stage, the Emergency Physician will have the competence which will enable him to be a real "team leader".

  18. International emergency medicine: a review of the literature from 2010.

    PubMed

    Aschkenasy, Miriam; Arnold, Kris; Foran, Mark; Lippert, Suzanne; Schroeder, Erika D; Bertsch, Karina; Levine, Adam C

    2011-08-01

    The International Emergency Medicine (IEM) Literature Review aims to highlight and disseminate high-quality global EM research in the fields of EM development, disaster and humanitarian response, and emergency care in resource-limited settings. For this review, we conducted a Medline search for articles published between January 1 and December 31, 2010, using a set of international and EM search terms and a manual search of journals that have produced large numbers of IEM articles for past reviews. This search produced 6,936 articles, which were divided among 20 reviewers who screened them using established inclusion and exclusion criteria to select articles relevant to the field of IEM. Two-hundred articles were selected by at least one reviewer and approved by an editor for scoring. Two independent reviewers using a standardized and predetermined set of criteria then scored each of the 200 articles. The 27 top-scoring articles were chosen for full review. The articles this year trended toward evidence-based research for treatment and care options in resource-limited settings, with an emphasis on childhood illness and obstetric care. These articles represent examples of high-quality international emergency research that is currently ongoing in high-, middle-, and low-income countries alike. This article is not intended to serve as a systematic review or clinical guideline but is instead meant to be a selection of current high-quality IEM literature, with the hope that it will foster further growth in the field, highlight evidence-based practice, and encourage discourse. © 2011 by the Society for Academic Emergency Medicine.

  19. An Analysis of State Public Health Emergency Declarations

    PubMed Central

    2014-01-01

    Disaster responses often involve coordination among multiple levels of government and public and private sector collaboration. When emergencies raise health concerns, governments must include public health and health care systems in their response. A state government’s declaration of “public health emergency” can provide that state’s health sector with flexibility and guidance about response parameters. Although events including Hurricanes Katrina and Sandy and the H1N1 influenza outbreak provided opportunities for states to deploy their public health emergency powers, little has been reported about how states have used their authority to declare a public health emergency. I present a systematic identification and analysis of states’ public health emergency declarations, examine why these declarations were issued, and discuss their potential value. PMID:25033156

  20. Evaluation of factors affecting psychological morbidity in emergency medicine practitioners.

    PubMed

    Momeni, Mehdi; Fahim, Farshid; Vahidi, Elnaz; Nejati, Amir; Saeedi, Morteza

    2016-01-01

    Assessing and evaluating mental health status can provide educational planners valuable information to predict the quality of physicians' performance at work. These data can help physicians to practice in the most desired way. The study aimed to evaluate factors affecting psychological morbidity in Iranian emergency medicine practitioners at educational hospitals of Tehran. In this cross sectional study 204 participants (emergency medicine residents and specialists) from educational hospitals of Tehran were recruited and their psychological morbidity was assessed by using a 28-question Goldberg General Health Questionnaire (GHQ-28). Somatization, anxiety and sleep disorders, social dysfunction and depression were evaluated among practitioners and compared to demographic and job related variables. Two hundreds and four participants consisting of 146 (71.6%) males and 58 (28.4%) females were evaluated. Of all participants, 55 (27%) were single and 149 (73%) were married. Most of our participants (40.2%) were between 30-35 years old. By using GHQ-28, 129 (63.2%) were recognized as normal and 75 (36.8%) suffered some mental health disorders. There was a significant gender difference between normal practitioners and practitioners with disorder (P=0.02) while marital status had no significant difference (P=0.2). Only 19 (9.3%) declared having some major mental health issue in the previous month. Females encountered more mental health disorders than male (P=0.02) and the most common disorder observed was somatization (P=0.006).

  1. Nanotechnology in reproductive medicine: emerging applications of nanomaterials.

    PubMed

    Barkalina, Natalia; Charalambous, Charis; Jones, Celine; Coward, Kevin

    2014-07-01

    In the last decade, nanotechnology has been extensively introduced for biomedical applications, including bio-detection, drug delivery and diagnostic imaging, particularly in the field of cancer diagnostics and treatment. However, there is a growing trend towards the expansion of nanobiotechnological tools in a number of non-cancer applications. In this review, we discuss the emerging uses of nanotechnology in reproductive medicine and reproductive biology. For the first time, we summarise the available evidence regarding the use of nanomaterials as experimental tools for the detection and treatment of malignant and benign reproductive conditions. We also present an overview of potential applications for nanomaterials in reproductive biology, discuss the benefits and concerns associated with their use in a highly delicate system of reproductive tissues and gametes, and address the feasibility of this innovative and potentially controversial approach in the clinical setting and for investigative research into the mechanisms underlying reproductive diseases. This unique review paper focuses on the emerging use of nanotechnology in reproductive medicine and reproductive biology, highlighting the role of nanomaterials in the detection and treatment of various reproductive conditions, keeping in mind the benefits and potential concerns associated with nanomaterial use in the delicate system of reproductive tissue and gametes. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Evaluating Emergency Medicine Faculty at End-of-Shift

    PubMed Central

    Kovach, Regina A.; Griffen, David L.; Francis, Mark L.

    2010-01-01

    Introduction Faculty often evaluate learners in the emergency department (ED) at the end of each shift. In contrast, learners usually evaluate faculty only at the end of a rotation. In December 2007 Southern Illinois University School of Medicine changed its evaluation process, requiring ED trainees to complete end-of-shift evaluations of faculty. Objective Determine the feasibility and acceptance of end-of-shift evaluations for emergency medicine faculty. Methods We conducted this one-year observational study at two hospitals with 120,000 combined annual ED visits. Trainees (residents and students) anonymously completed seven-item shift evaluations and placed them in a locked box. Trainees and faculty completed a survey about the new process. Results During the study, trainees were assigned 699 shifts, and 633 end-of-shift evaluations were collected for a completion rate of 91%. The median number of ratings per faculty was 31, and the median number of comments was 11 for each faculty. The survey was completed by 16/22 (73%) faculty and 41/69 (59%) trainees. A majority of faculty (86%) and trainees (76%) felt comfortable being evaluated at end-of-shift. No trainees felt it was a time burden. Conclusion Evaluating faculty following an ED shift is feasible. End-of-shift faculty evaluations are accepted by trainees and faculty. PMID:21293771

  3. Information technology model for evaluating emergency medicine teaching

    NASA Astrophysics Data System (ADS)

    Vorbach, James; Ryan, James

    1996-02-01

    This paper describes work in progress to develop an Information Technology (IT) model and supporting information system for the evaluation of clinical teaching in the Emergency Medicine (EM) Department of North Shore University Hospital. In the academic hospital setting student physicians, i.e. residents, and faculty function daily in their dual roles as teachers and students respectively, and as health care providers. Databases exist that are used to evaluate both groups in either academic or clinical performance, but rarely has this information been integrated to analyze the relationship between academic performance and the ability to care for patients. The goal of the IT model is to improve the quality of teaching of EM physicians by enabling the development of integrable metrics for faculty and resident evaluation. The IT model will include (1) methods for tracking residents in order to develop experimental databases; (2) methods to integrate lecture evaluation, clinical performance, resident evaluation, and quality assurance databases; and (3) a patient flow system to monitor patient rooms and the waiting area in the Emergency Medicine Department, to record and display status of medical orders, and to collect data for analyses.

  4. Determinants of public trust in complementary and alternative medicine

    PubMed Central

    2010-01-01

    Background In the Netherlands, public trust in conventional medicine is relatively high. There is reason to believe that public trust in complementary and alternative medicine (CAM) is rated lower. The aim of this study is to gain insight into public trust in CAM and the determinants that lie at the root of it. We hypothesized that public trust in CAM is related to (perceived) institutional guarantees, media information on CAM, information from people's social network, personal experiences, the role of general practitioners (GPs) and trust in conventional medicine. Methods A postal questionnaire on public trust in CAM was mailed to 1358 members of the Health Care Consumer Panel. 65% of the questionnaires were returned. Data were analysed using frequencies, ANOVA, post hoc testing and linear regression analyses. Results In the total sample, the level of public trust in CAM was a 5.05 on average on a scale of 1-10. 40.7% was CAM user (current or past) and displayed significantly higher levels of trust toward CAM than CAM non users. In the total sample, public trust in CAM was related to institutional guarantees, negative media information, positive and negative information reported by their social network and people's personal experiences with CAM. For non users, trust is mostly associated with institutional guarantees. For users, personal experiences are most important. For both users and non users, trust levels in CAM are affected by negative media information. Public trust in CAM is for CAM users related to positive information and for non users to negative information from their network. Conclusions In the Netherlands, CAM is trusted less than conventional medicine. The hypotheses on institutional guarantees, media information, information from the network and people's personal experiences are confirmed by our study for the total sample, CAM non users and users. The other hypotheses are rejected. PMID:20226015

  5. Terrorism and emergent challenges in public health.

    PubMed

    O'Boyle, Irene; Johnson, James A; Simms, Michelle; Metzroth, Robert

    2008-01-01

    The authors explore the complexity of challenges facing the public health community in an era increasingly defined by terrorism. The public health and associated political structure in this country has much to do to better coordinate its' efforts in an effective way. Solutions will ultimately come from partnerships between government agencies, community organizations, the business community, and international interests.

  6. 21 CFR 25.16 - Public health and safety emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA and...

  7. 21 CFR 25.16 - Public health and safety emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA and...

  8. 21 CFR 25.16 - Public health and safety emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA and...

  9. Public Value Mapping of Equity in Emerging Nanomedicine

    ERIC Educational Resources Information Center

    Slade, Catherine P.

    2011-01-01

    Public values failure occurs when the market and the public sector fail to provide goods and services required to achieve the core values of society such as equity (Bozeman 2007). That public policy for emerging health technologies should address intrinsic societal values such as equity is not a novel concept. However, the ways that the public…

  10. Public Value Mapping of Equity in Emerging Nanomedicine

    ERIC Educational Resources Information Center

    Slade, Catherine P.

    2011-01-01

    Public values failure occurs when the market and the public sector fail to provide goods and services required to achieve the core values of society such as equity (Bozeman 2007). That public policy for emerging health technologies should address intrinsic societal values such as equity is not a novel concept. However, the ways that the public…

  11. A Public Health Agenda for Traditional, Complementary, and Alternative Medicine

    PubMed Central

    Bodeker, Gerard; Kronenberg, Fredi

    2002-01-01

    Traditional medicine (a term used here to denote the indigenous health traditions of the world) and complementary and alternative medicine (T/CAM) have, in the past 10 years, claimed an increasing share of the public’s awareness and the agenda of medical researchers. Studies have documented that about half the population of many industrialized countries now use T/CAM, and the proportion is as high as 80% in many developing countries. Most research has focused on clinical and experimental medicine (safety, efficacy, and mechanism of action) and regulatory issues, to the general neglect of public health dimensions. Public health research must consider social, cultural, political, and economic contexts to maximize the contribution of T/CAM to health care systems globally. PMID:12356597

  12. Date fruits (Phoenix dactylifera Linn): an emerging medicinal food.

    PubMed

    Vayalil, Praveen K

    2012-01-01

    Date palm is one of the oldest trees cultivated by man. In the folk-lore, date fruits have been ascribed to have many medicinal properties when consumed either alone or in combination with other herbs. Although, fruit of the date palm served as the staple food for millions of people around the world for several centuries, studies on the health benefits are inadequate and hardly recognized as a healthy food by the health professionals and the public. In recent years, an explosion of interest in the numerous health benefits of dates had led to many in vitro and animal studies as well as the identification and quantification of various classes of phytochemicals. On the basis of available documentation in the literature on the nutritional and phytochemical composition, it is apparent that the date fruits are highly nutritious and may have several potential health benefits. Although dates are sugar-packed, many date varieties are low GI diet and refutes the dogma that dates are similar to candies and regular consumption would develop chronic diseases. More investigations in these areas would validate its beneficial effects, mechanisms of actions, and fully appreciate as a potential medicinal food for humans all around the world. Therefore, in this review we summarize the phytochemical composition, nutritional significance, and potential health benefits of date fruit consumption and discuss its great potential as a medicinal food for a number of diseases inflicting human beings.

  13. Portfolios: possibilities for addressing emergency medicine resident competencies.

    PubMed

    O'Sullivan, Patricia; Greene, Constance

    2002-11-01

    Portfolios are an innovative approach to evaluate the competency of emergency medicine residents. Three key characteristics add to their attractiveness. First, portfolios draw from the resident's actual work. Second, they require self-reflection on the part of the resident. Third, they are inherently practice-based learning since residents must review and consider their practice in order to begin the portfolio. This paper illustrates five different applications of portfolios. First, portfolios are applied to evaluating specific competencies as part of the training of emergency physicians. While evaluating specific competencies, the portfolio captures aspects of the general competencies. Second, the article illustrates using portfolios as a way to address a specific residency review committee (RRC) requirement such as follow-ups. Third is a description of how portfolios can be used to evaluate resident conferences capturing the competency of practice-based learning and possibly other competencies such as medical knowledge and patient care. Fourth, the authors of the article designed a portfolio as a way to demonstrate clinical competence. Fifth, they elaborate as to how a continuous quality improvement project could be cast within the portfolio framework. They provide some guidance concerning issues to address when designing the portfolios. Portfolios are carefully structured and not haphazard collections of materials. Following criteria is important in maintaining the validity of the portfolio as well as contributing to reliability. The portfolios can enhance the relationship between faculty and residents since faculty will suggest cases, discuss anomalies, and interact with the residents around the portfolio. The authors believe that in general portfolios can cover many of the general competencies specified by the ACGME while still focusing on issues important to emergency medicine. The authors believe that portfolios provide an approach to evaluation commensurate

  14. Assessing research methodology training needs in emergency medicine.

    PubMed

    Supino, P G; Richardson, L D

    1999-04-01

    To determine the perceptions of emergency medicine (EM) academic faculty leaders and other academic emergency physicians regarding importance and knowledge of specific research methodology content areas and training priorities. The authors conducted a confidential mail survey of 52 EM academic chairs, 112 residency directors, 116 research directors, and 400 randomly selected other members of the Society for Academic Emergency Medicine (SAEM). Respondents rated the importance of knowledge about each of 12 content areas for enhancing research productivity, rated their own knowledge of these areas, and identified training priorities. Standard descriptive statistics were used to characterize the study population; subgroup differences were examined by nonparametric statistics. 551 (81%) of those sampled returned surveys. Most (90%) respondents thought that knowledge about all selected content areas was important for enhancing research productivity; however, 7-37% (depending on the topic) reported little knowledge or experience in specific areas. Research directors reported highest overall knowledge levels (p < 0.001), followed by chairs, residency directors, and other SAEM members. Top training priorities (identified by all subgroups) included study planning (70%), problem identification/hypothesis construction (41%), and proposal writing (38%). These data support the continued need to offer broad training in research methodology, but suggest that greater emphasis be given to concepts involved in initiating and planning a study and to strengthening research proposal writing skills. These results should be of interest to academic departments who must address their own training needs, and help support the development of research methodology curricula on regional and national levels to advance the state of research in the specialty of EM.

  15. Emergency medicine in the developing world: a Delphi study.

    PubMed

    Hodkinson, Peter W; Wallis, Lee A

    2010-07-01

    Emergency medicine (EM) as a specialty has developed rapidly in the western world, but remains largely immature in developing nations. There is an urgent need for emergency services, but no clear guidelines are available on the priorities for establishing EM in the developing world. This study seeks to establish consensus on key areas of EM development in developing world settings, with respect to scope of EM, staffing needs, training requirements, and research priorities. A three-round Delphi study was conducted via e-mail. A panel was convened of 50 EM specialists or equivalent, with experience in or interest in EM in the developing world. In the first round, panelists provided free-text statements on scope, staffing, training, and research priorities for EM in the developing world. A five-point Likert scale was used to rate agreement with the statements in Rounds 2 and 3. Consensus statements are presented as a series of synopsis statements for each of the four major themes. A total of 168 of 208 statements (81%) had reached consensus at the end of the study. Key areas in which consensus was reached included EM being a specialist-driven service, with substantial role for nonphysicians. International training courses should be adapted to local needs. EM research in developing countries should be clinically driven and focus on local issues of importance. The scope and function of EM and relationships with other specialties are defined. Unambiguous principles are laid out for the development of the specialty in developing world environments. The next step required in this process is translation into practical guidelines for the development of EM in developing world settings where they may be used to drive policy, protocols, and research. 2010 by the Society for Academic Emergency Medicine

  16. Do emergency ultrasound fellowship programs impact emergency medicine residents' ultrasound education?

    PubMed

    Adhikari, Srikar; Raio, Christopher; Morrison, Daniel; Tsung, James; Leech, Stephen; Meer, Jehangir; Lyon, Matthew; Lopez, Fernando; Akhtar, Saadia

    2014-06-01

    Recent years have seen a rapid proliferation of emergency ultrasound (EUS) programs in the United States. To date, there is no evidence supporting that EUS fellowships enhance residents' ultrasound (US) educational experiences. The purpose of this study was to determine the impact of EUS fellowships on emergency medicine (EM) residents' US education. We conducted a cross-sectional study at 9 academic medical centers. A questionnaire on US education and bedside US use was pilot tested and given to EM residents. The primary outcomes included the number of US examinations performed, scope of bedside US applications, barriers to residents' US education, and US use in the emergency department. The secondary outcomes were factors that would impact residents' US education. The outcomes were compared between residency programs with and without EUS fellowships. A total of 244 EM residents participated in this study. Thirty percent (95% confidence interval, 24%-35%) reported they had performed more than 150 scans. Residents in programs with EUS fellowships reported performing more scans than those in programs without fellowships (P = .04). Significant differences were noted in most applications of bedside US between residency programs with and without fellowships (P < .05). There were also significant differences in the barriers to US education between residency programs with and without fellowships (P < .05). Emergency US fellowship programs had a positive impact on residents' US educational experiences. Emergency medicine residents performed more scans overall and also used bedside US for more advanced applications in programs with EUS fellowships. © 2014 by the American Institute of Ultrasound in Medicine.

  17. Emergency preparedness and public health systems lessons for developing countries.

    PubMed

    Kruk, Margaret E

    2008-06-01

    Low- and middle-income countries, where emerging diseases often make their debut, are also likely to bear the harshest consequences of a potential influenza pandemic. Yet public health systems in developing countries are underfunded, understaffed, and in many cases struggling to deal with the existing burden of disease. As a result, developed countries are beginning to expand assistance for emergency preparedness to the developing world. Given developing countries' weak infrastructure and many competing public health priorities, it is not clear how to best direct these resources. Evidence from the U.S. and other developed countries suggests that some investments in bioterror and pandemic emergency preparedness, although initially implemented as vertical programs, have the potential to strengthen the general public health infrastructure. This experience may hold some lessons for how global funds for emergency preparedness could be invested in developing countries to support struggling public health systems in responding to current health priorities as well as potential future public health threats.

  18. Status report: Development of emergency medicine research since the Macy Report.

    PubMed

    Pollack, Charles V; Hollander, Judd E; O'Neil, Brian J; Neumar, Robert W; Summers, Richard; Camargo, Carlos A; Younger, John G; Callaway, Clifton W; Gallagher, E John; Kellermann, Arthur L; Krause, Gary S; Schafermeyer, Robert W; Sloan, Edward; Stern, Susan

    2003-07-01

    In Williamsburg, VA, April 17 to 20, 1994, the Josiah Macy, Jr. Foundation sponsored a conference entitled "The Role of Emergency Medicine in the Future of American Medical Care," a report on which was published in Annals in 1995. This report promulgated recommendations for the development and enhancement of academic departments of emergency medicine and a conference to develop an agenda for research in emergency medicine. The American College of Emergency Physicians' Research Committee, along with several ad hoc members, presents updates in several of the areas addressed by the Macy Report and subsequent conferences, as a status report for the development of emergency medicine research as a whole, as of late 2002.

  19. Resource contribution by Canadian faculties of medicine to the discipline of emergency medicine.

    PubMed

    Steiner, I P; Yoon, P W; Goldsand, G; Rowe, B H

    2001-01-01

    Undergraduate and postgraduate emergency medicine (EM) education has developed rapidly over the last 20 years. Our objective was to establish a national educational inventory, cataloguing the human and financial resources provided to EM programs by Canadian faculties of medicine. A 17-question survey was distributed to all 27 Canadian EM program directors, representing 11 Royal College of Physicians and Surgeons of Canada (RCPSC) programs and 16 College of Family Physicians of Canada (CFPC-EM) programs. The questionnaire addressed teaching responsibilities, teaching support and academic support in each program. All 27 program directors returned valid questionnaires. Annually, an estimated 3,049 students and residents participate in EM learning. This includes 1,369 undergraduates (45%), 1,621 postgraduates (53%) and 59 others (2%). Of the postgraduates, 173 are EM residents -- 92 (53%) in RCPSC programs and 81 (47%) in CFPC-EM programs. Overall, 587 EM faculty teach residents and students, but only 36 (6%) of these hold academic geographical full time positions. At the university level, all 16 CFPC-EM programs are administered by departments of family medicine. Of 11 RCPSC programs, 1 has full departmental status, 2 are free-standing divisions, 3 are administered through family medicine, 3 through medicine, 1 through surgery and 1 by other arrangements. Currently 8 programs (30%) have associate faculty, 14 (52%) have designated research directors and 10 (37%) describe other human resources. Sixteen (59%) programs receive direct financial and administrative support and 17 (63%) receive financial support for resident initiatives. Only 8 program directors (30%) perceive that they are receiving adequate support. Despite major teaching and clinical responsibilities within the faculties of medicine, Canadian EM programs are poorly supported. Further investment of human and financial and human resources is required.

  20. Development of an Emergency Medicine Simulation Fellowship Consensus Curriculum: Initiative of the Society for Academic Emergency Medicine Simulation Academy.

    PubMed

    Frallicciardi, Alise; Vora, Samreen; Bentley, Suzanne; Nadir, Nur-Ain; Cassara, Michael; Hart, Danielle; Park, Chan; Cheng, Adam; Aghera, Amish; Moadel, Tiffany; Dobiesz, Valerie

    2016-09-01

    There is currently no consolidated list of existing simulation fellowship programs in emergency medicine (EM). In addition, there are no universally accepted or expected standards for core curricular content. The objective of this project is to develop consensus-based core content for EM simulation fellowships to help frame the critical components of such training programs. This paper delineates the process used to develop consensus curriculum content for EM simulation fellowships. EM simulation fellowship curricula were collected. Curricular content was reviewed and compiled by simulation experts and validated utilizing survey methodology, and consensus was obtained using a modified Delphi methodology. Fifteen EM simulation fellowship curricula were obtained and analyzed. Two rounds of a modified Delphi survey were conducted. The final proposed core curriculum content contains 47 elements in nine domains with 14 optional elements. The proposed consensus content will provide current and future fellowships a foundation on which to build their own specific and detailed fellowship curricula. Such standardization will ultimately increase the transparency of training programs for future trainees and potential employers. © 2016 by the Society for Academic Emergency Medicine.

  1. Pediatric emergency medicine fellow training in ultrasound: consensus educational guidelines.

    PubMed

    Vieira, Rebecca L; Hsu, Deborah; Nagler, Joshua; Chen, Lei; Gallagher, Rachel; Levy, Jason A

    2013-03-01

    The importance of point-of-care emergency ultrasound (EUS) to the practice of emergency medicine (EM) is well established, and mounting research continues to demonstrate how EUS can benefit pediatric emergency department (ED) patients. As members of the EM community, pediatric EM (PEM) physicians should understand the potential value of EUS and seek opportunities to incorporate EUS into their daily practice. Currently, EUS education and training is at an early developmental stage for PEM fellows and varies greatly between programs. The goal of this article is to provide consensus education guidelines and to describe a sample curriculum that can be used by PEM fellowship programs when developing or revising their US training curricula. The authors recognize that programs may be at different stages of EUS development and will consequently need to tailor curricula to individual institutional needs and capabilities. This guideline was developed through a collaborative process between EUS educators and members of the American Academy of Pediatrics Section of EM Fellowship Directors Subcommittee. The guideline includes the following topics: important considerations regarding EUS in PEM, PEM US program framework, PEM US curriculum, PEM US education program, and competency assessment.

  2. The future of emergency medicine: an evolutionary perspective.

    PubMed

    Sklar, David P; Handel, Daniel A; Hoekstra, James; Baren, Jill M; Zink, Brian; Hedges, Jerris R

    2010-03-01

    Emergency medicine (EM) has grown rapidly over the past 50 years, evolving from a specialty defined by its locational identity--a hospital receiving room--to the specialty picked fourth-most-frequently by graduating U.S. medical students and to being the focal point of clinical care and of research on time-sensitive medical conditions. The authors review the forces that led to the growth of EM and those that will shape its future--in particular, cost, quality, and technology. A balancing of cost and quality considerations will likely drive EM education and research endeavors. The future of the field will be determined in part by resolution of the tension between the current inefficient conditions of emergency departments (EDs), which are crowded because of the temporary boarding of admitted patients for whom a bed is not yet ready, and the desired provision of quality care under emergent conditions. That is, patients with stroke, myocardial infarction, sepsis, or severe injuries from trauma require a working diagnosis and interventions that are initiated shortly after presentation, but ED personnel distracted by the demands of caring for boarded patients are unable to deliver optimal ED care. The reduction or elimination of boarding will enhance education and research within EDs and will contribute to an efficient system of high-quality EM services.

  3. Public Health and Disasters: An Emerging Translational and Implementation Science, Not "Lessons Learned".

    PubMed

    Koenig, Kristi L; Schultz, Carl H; Gould Runnerstrom, Miryha; Ogunseitan, Oladele A

    2017-03-23

    Disaster Medicine is a relatively new multidisciplinary field of science with clear public health implications as it focuses on improving outcomes for populations rather than for individual patients. As with any other scientific discipline, the goal of public health and disaster research is to create new knowledge and transfer evidence-based data to improve public health. The phrase "lessons learned" has crept into the disaster lexicon but must be permanently erased as it has no place in the scientific method. The second edition of Koenig and Schultz's Disaster Medicine: Comprehensive Principles & Practice adds to the growing knowledge base of this emerging specialty and explains why "lessons learned" should be discarded from the associated vocabulary. (Disaster Med Public Health Preparedness. 2017;page 1 of 2).

  4. Critical care medicine for emerging Middle East respiratory syndrome: Which point to be considered?

    PubMed

    Wiwanitkit, Viroj

    2015-09-01

    The Middle East respiratory syndrome (MERS) is a new emerging respiratory tract infection. This coronavirus infection is firstly reported from the Middle East, and it becomes threat for the global public health at present due to its existence in a remote area such as USA and Korea. The concern on the management of the patients is very important. Since most of the patients can develop severe respiratory illness and critical care management is needed, the issue on critical care for MERS is the topic to be discussed in critical medicine.

  5. [Critical incidents in preclinical emergency airway management : Evaluation of the CIRS emergency medicine databank].

    PubMed

    Hohenstein, C; Schultheis, K; Winning, J; Rupp, P; Fleischmann, T

    2013-09-01

    Many patients are victims of disastrous incidents during medical interventions. One of the obligations of physicians is to identify these incidents and to subsequently develop preventive strategies in order to prevent future events. Airway management and prehospital emergency medicine are of particular interest as both categories frequently show very dynamic developments. Incidents in this particular area can lead to serious injury but at the same time it has never been analyzed what kind of incidents might harm patients during prehospital airway management. The German website http://www.cirs-notfallmedizin.de (CIRS critical incident reporting systems) offers anonymous reporting of critical incidents in prehospital emergency medicine. All incidents reported between 2005 and 2012 were screened to identify those which were concerned with airway management and four experts in this field analyzed the incidents and performed a root cause analysis. The database contained 845 reports. The authors considered 144 reports to be airway management related and identified 10 root causes: indications for intubation but no intubation performed (n = 8), no indications for intubation but intubation attempt performed (n = 7), wrong medication (n = 25), insufficient practical skills (n = 46), no use of alternative airway management (n = 7), insufficient handling before or after intubation (n = 27), defect equipment (n = 28), lack of equipment (n = 31), others (n = 18) and factors that cannot be influenced (n = 12). The incidents that were reported via the website http://www.cirs-notfallmedizin.de and that occurred during airway management in prehospital emergency medicine are described. To improve practical airway management skills of emergency physicians are one of the most important tasks in order to prevent critical incidents and are discussed in the article.

  6. Building public confidence in emergency management.

    PubMed

    Pearce, Tony

    2016-01-01

    Over the years the State of Victoria has suffered many disasters, some of them resulting in extensive community, economic and environmental loss. A number of significant events, including the 2009 Victorian bushfires, major flood events in 2010-11 and their subsequent inquiries have resulted in the biggest overhaul of Victoria's emergency management arrangements since 1983. One significant element of the new arrangements is the inclusion of an entity whose role it is to assure the emergency management arrangements at the system level--the first time such a role has existed. This paper will describe the reform programme currently underway in Victoria, as well as the governance and structural arrangements that have been put in place, before detailing the assurance processes that are being implemented.

  7. Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine.

    PubMed

    Gorelick, Marc H; Schremmer, Robert; Ruch-Ross, Holly; Radabaugh, Carrie; Selbst, Steven

    2016-01-01

    Changes in health care delivery and graduate medical education have important consequences for the workforce in pediatric emergency medicine (PEM). This study compared career preparation and potential attrition of the PEM workforce with the prior assessment from 1998. An e-mail survey was sent to members of the American Academy of Pediatrics (AAP) Section on EM and to non-AAP members board certified in PEM. Information on demographics, practice characteristics and professional activities, career preparation, future plans, and burnout (using two validated screening questions) was analyzed using standard descriptive statistics. Of 2,120 surveys mailed, 895 responses were received (40.8% response). Over half (53.7%) of respondents were female, compared with 44% in 1998. The majority (62.9%) practiced in the emergency department (ED) of a free-standing children's hospital. The distribution of professional activities was similar to that reported in 1998, with the majority of time (60%) spent in direct patient care. Half indicated involvement in research, and almost half had dedicated time for other activities, including emergency medical services (7.3%), disaster (6.9%), child abuse (5.0%), transport (3.6%), toxicology (2.3% of respondents), and other (13.6%); additionally, 21.3% had dedicated time for quality/safety. Respondents were highly satisfied (95.6%) with fellowship preparation for clinical care, but less satisfied with preparation for research (49.2%) and administration (38.7%). However, satisfaction with nonclinical training was higher for those within 10 years of medical school graduation. Forty-six percent plan to change clinical activity in the next 5 years, including reducing hours, changing shifts, or retiring. Overall, 11.9% of all respondents, including 20.1% of women and 2.6% of men (p < 0.001), report currently working part time. Large majorities endorsed feeling burned out at work (88.5%) or more callous toward people as a result of work (67

  8. Federal legal preparedness tools for facilitating medical countermeasure use during public health emergencies.

    PubMed

    Courtney, Brooke; Sherman, Susan; Penn, Matthew

    2013-03-01

    Preparing for and responding to public health emergencies involving medical countermeasures (MCMs) raise often complex legal challenges and questions among response stakeholders at the local, state, and federal levels. This includes concerns about emergency legal authorities, liability, emergency use of regulated medical products, and regulations that might enhance or hinder public health response goals. In this article, lawyers from the U.S. Department of Health and Human Services' (HHS) Office of the General Counsel (OGC), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration (FDA) discuss federal legal tools that are critical to enhancing MCM legal preparedness for public health emergencies, with an emphasis on the legal mechanisms that can be used to facilitate the emergency use of countermeasures. Specifically, the authors describe the Public Readiness and Emergency Preparedness (PREP) Act and Emergency Use Authorization (EUA) authority, outlining the conditions under which these tools can be utilized and providing examples of how they have supported both pre-event (e.g., doxycycline mass dispensing preparedness for anthrax) and intra-event (e.g., 2009 H1N1 influenza pandemic response) activities. © 2013 American Society of Law, Medicine & Ethics, Inc.

  9. Integration of digital imaging into emergency medicine education.

    PubMed

    Chan, Lisa; Reilly, Kevin M

    2002-01-01

    Medical education has adopted the use of digital photography and other computer technology, which has changed the face of the classroom. Today's presentations couple a computer and digital projection system to create powerful teaching tools. Integration of quality medical images enhances presentations in a way never before possible and at a much lower cost. Changes to presentations can occur rapidly, at a fraction of the cost of slides. However, obtaining quality digital images for presentations is problematic. Services are available on the Internet that offer images for sale, but the cost to obtain images is high. Many institutions of higher learning provide images on the Internet for free, but the quality, number of available images, server capacity, and issues of consent limit the availability of these images. The authors describe their experience in collecting more than 20,000 clinical photographs, and provide examples of their use in emergency medicine education.

  10. Education Scholarship and its Impact on Emergency Medicine Education

    PubMed Central

    Sherbino, Jonathan

    2015-01-01

    Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development. PMID:26594270

  11. Education Scholarship and its Impact on Emergency Medicine Education.

    PubMed

    Sherbino, Jonathan

    2015-11-01

    Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development.

  12. Simulation in medical school education: review for emergency medicine.

    PubMed

    Chakravarthy, Bharath; Ter Haar, Elizabeth; Bhat, Srinidhi Subraya; McCoy, Christopher Eric; Denmark, T Kent; Lotfipour, Shahram

    2011-11-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

  13. The current state of hospital-based emergency medicine in Germany.

    PubMed

    Bey, Tareg A; Hahn, Sigrid A; Moecke, Heinzpeter

    2008-12-01

    Germany has a long tradition of having physicians, often anesthesiologists with additional training in emergency medicine, deliver prehospital emergency care. Hospital-based emergency medicine in Germany also differs significantly from the Anglo-American model, and until recently having separate emergency rooms for different departments was the norm. In the past decade, many hospitals have created "centralized emergency departments" [Zentrale Notaufnahme (ZNAs)]. There is ongoing debate about the training and certification of physicians working in the ZNAs and whether Germany will adopt a specialty board certification for emergency medicine.

  14. Emergence of occupational medicine in Victorian times1

    PubMed Central

    Lee, W. R.

    1973-01-01

    Lee, W. R. (1973).British Journal of Industrial Medicine,30, 118-124. Emergence of occupational medicine in Victorian times. The events surrounding the establishment and development of legislation to protect the health of people at work in Victorian times are already well documented. This paper deals with some other aspects of the development of occupational medicine. Medical opinions at the time did not always see the misuse of child labour as due simply to avaricious mill owners, but in part due to the parents and in part to the workmen subcontractors. The establishment of the certifying surgeons is briefly reviewed and their coming together to form an association in 1868 may be related to questions about the need for medical certificates of age which were being requested by the many factory owners brought under factory legislation for the first time in 1864 and 1867. The plight of injured workmen and their dependents was early recognized, although it was late in the Victorian era before any statutory provision was made for them. The idea of linking compensation with preventive measures came to the fore in 1845 when some Manchester doctors, later supported by Edwin Chadwick, examined the workings at the Woodhead railway tunnel across the Pennines. When compensation legislation was passed some half a century later the idea was lost, and to this day compensation for and prevention of industrial injury and disease remain separated. The change of industrial diseases from a medical curiosity to a problem requiring State intervention is traced over the latter part of the Victorian era. The whole piecemeal pattern illustrating the precept that `social problems come first, social philosophy after' has persisted until the far-reaching changes in health and safety legislation of the present day. PMID:4267346

  15. Emerging paradigms in medicine: implications for the future of psychiatry.

    PubMed

    Lake, James

    2007-01-01

    The causes of mental illness remain obscure in spite of rapid progress in the neurosciences. This is due in part to the fact that contemporary biomedical psychiatry rests on philosophically and scientifically ambiguous ground. In Western medicine paradigms, theories from physics, chemistry, and biology form the basis of an explanatory model of illness, including mental illness. Symptoms are conceptualized as subjective descriptions of effects caused by factors characterized in empirical terms. Conventional biomedicine asserts that all causes of illness, and by extension, mechanisms of action underlying legitimate treatment approaches, rest on biological processes that can be described in the reductionist language of Western science. However, in contemporary Western psychiatry, there is no single adequate explanatory model of the causes of mental illness. What remains are competing psychodynamic, genetic, endocrinologic, and neurobiological models of symptom formation reflecting disparate ideological positions and diverse clinical training backgrounds of mental health professionals. There is no unifying theory in psychiatry because no single explanatory model has been confirmed as more valid than any other. I hypothesize in this article that the synthesis of ideas and clinical approaches from Western biomedicine and non-Western systems of medicine based on understandings of human consciousness, the neurosciences, complexity theory, and quantum field theory, will lead to rapid evolution of conventional Western biomedical psychiatry toward truly integrative mental healthcare. The result will be the emergence of an integrative mental healthcare model that will more adequately address the disparate causes, conditions, and meanings of symptoms combining multimodal approaches from Western biomedicine and non-Western systems of medicine.

  16. Increasing Patient Safety Event Reporting in an Emergency Medicine Residency.

    PubMed

    Steen, Sven; Jaeger, Cassie; Price, Lindsay; Griffen, David

    2017-01-01

    Patient safety event reporting is an important component for fostering a culture of safety. Our tertiary care hospital utilizes a computerized patient safety event reporting system that has been historically underutilized by residents and faculty, despite encouragement of its use. The objective of this quality project was to increase patient safety event reporting within our Emergency Medicine residency program. Knowledge of event reporting was evaluated with a survey. Eighteen residents and five faculty participated in a formal educational session on event reporting followed by feedback every two months on events reported and actions taken. The educational session included description of which events to report and the logistics of accessing the reporting system. Participants received a survey after the educational intervention to assess resident familiarity and comfort with using the system. The total number of events reported was obtained before and after the educational session. After the educational session, residents reported being more confident in knowing what to report as a patient safety event, knowing how to report events, how to access the reporting tool, and how to enter a patient safety event. In the 14 months preceding the educational session, an average of 0.4 events were reported per month from the residency. In the nine months following the educational session, an average of 3.7 events were reported per month by the residency. In addition, the reported events resulted in meaningful actions taken by the hospital to improve patient safety, which were shared with the residents. Improvement efforts including an educational session, feedback to the residency of events reported, and communication of improvements resulting from reported events successfully increased the frequency of safety event reporting in an Emergency Medicine residency.

  17. Virtual Alternative to the Oral Examination for Emergency Medicine Residents

    PubMed Central

    McGrath, Jillian; Kman, Nicholas; Danforth, Douglas; Bahner, David P.; Khandelwal, Sorabh; Martin, Daniel R.; Nagel, Rollin; Verbeck, Nicole; Way, David P.; Nelson, Richard

    2015-01-01

    Introduction The oral examination is a traditional method for assessing the developing physician’s medical knowledge, clinical reasoning and interpersonal skills. The typical oral examination is a face-to-face encounter in which examiners quiz examinees on how they would confront a patient case. The advantage of the oral exam is that the examiner can adapt questions to the examinee’s response. The disadvantage is the potential for examiner bias and intimidation. Computer-based virtual simulation technology has been widely used in the gaming industry. We wondered whether virtual simulation could serve as a practical format for delivery of an oral examination. For this project, we compared the attitudes and performance of emergency medicine (EM) residents who took our traditional oral exam to those who took the exam using virtual simulation. Methods EM residents (n=35) were randomized to a traditional oral examination format (n=17) or a simulated virtual examination format (n=18) conducted within an immersive learning environment, Second Life (SL). Proctors scored residents using the American Board of Emergency Medicine oral examination assessment instruments, which included execution of critical actions and ratings on eight competency categories (1–8 scale). Study participants were also surveyed about their oral examination experience. Results We observed no differences between virtual and traditional groups on critical action scores or scores on eight competency categories. However, we noted moderate effect sizes favoring the Second Life group on the clinical competence score. Examinees from both groups thought that their assessment was realistic, fair, objective, and efficient. Examinees from the virtual group reported a preference for the virtual format and felt that the format was less intimidating. Conclusion The virtual simulated oral examination was shown to be a feasible alternative to the traditional oral examination format for assessing EM residents

  18. A Survey of Emergency Medicine Residents’ Use of Educational Podcasts

    PubMed Central

    Riddell, Jeff; Swaminathan, Anand; Lee, Monica; Mohamed, Abdiwahab; Rogers, Rob; Rezaie, Salim R.

    2017-01-01

    Introduction Emergency medicine (EM) educational podcasts have become increasingly popular. Residents spend a greater percentage of their time listening to podcasts than they do using other educational materials. Despite this popularity, research into podcasting in the EM context is sparse. We aimed to determine EM residents’ consumption habits, optimal podcast preferences, and motivation for listening to EM podcasts. Methods We created a survey and emailed it to EM residents at all levels of training at 12 residencies across the United States from September 2015 to June 2016. In addition to demographics, the 20-question voluntary survey asked questions exploring three domains: habits, attention, and motivation. We used descriptive statistics to analyze results. Results Of the 605 residents invited to participate, 356 (n= 60.3%) completed the survey. The vast majority listen to podcasts at least once a month (88.8%). Two podcasts were the most popular by a wide margin, with 77.8% and 62.1% regularly listening to Emergency Medicine: Reviews and Perspectives (EM:RAP) and the EMCrit Podcast, respectively; 84.6% reported the ideal length of a podcast was less than 30 minutes. Residents reported their motivation to listen to EM podcasts was to “Keep up with current literature” (88.5%) and “Learn EM core content” (70.2%). Of those responding, 72.2% said podcasts change their clinical practice either “somewhat” or “very much.” Conclusion The results of this survey study suggest most residents listen to podcasts at least once a month, prefer podcasts less than 30 minutes in length, have several motivations for choosing podcasts, and report that podcasts change their clinical practice. PMID:28210357

  19. Management of Fever in postpneumococcal vaccine era: comparison of management practices by pediatric emergency medicine and general emergency medicine physicians.

    PubMed

    Khine, Hnin; Goldman, David L; Avner, Jeffrey R

    2014-01-01

    Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods. We retrospectively reviewed the charts of well-appearing febrile children aged 3-36 months who presented to a large urban children's hospital (PED), staffed by PEMPs, or a large urban general emergency department (GED), staffed by GEMPs. Demographics, immunization status, laboratory tests ordered, antibiotic usage, and final diagnoses were collected. Results. 224 cases from the PED and 237 cases from the GED were reviewed. Children seen by PEMPs had significantly less CXRs (23 (10.3%) versus 51 (21.5%), P = 0.001) and more rapid viral testing done (102 (45%) versus 40 (17%), P < 0.0001). A diagnosis of a viral infection was more common in the PED, while a diagnosis of bacterial infection (including otitis media) was more common in the GED. More GED patients were prescribed antibiotics (41% versus 27%, P = 0.002), while more PED patients were treated with oseltamivir (6.7% versus 0.4%, P < 0.001). Conclusions. Our findings identify important differences in the care of the young, well-appearing febrile child by PEMPs and GEMPs and highlight the need for standardization of care.

  20. Training Physician Investigators in Medicine and Public Health Research

    PubMed Central

    Jay, Melanie R.; Goldfrank, Lewis R.; Mendelsohn, Alan L.; Dreyer, Benard P.; Foltin, George L.; Lipkin, Mack; Schwartz, Mark D.

    2012-01-01

    Objectives. We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health. Methods. We developed a rigorous curriculum in public health content and research methods and fostered linkages with research mentors and local public health agencies. Didactic training provided the foundation for fellows’ mentored research initiatives, which addressed real-world challenges in advancing the health status of vulnerable urban populations. Results. Two multidisciplinary cohorts (6 per cohort) completed this 2-year degree-granting program and engaged in diverse public health research initiatives on topics such as improving pediatric care outcomes through health literacy interventions, reducing hospital readmission rates among urban poor with multiple comorbidities, increasing cancer screening uptake, and broadening the reach of addiction screening and intervention. The majority of fellows (10/12) published their fellowship work and currently have a career focused in public health–related research or practice (9/12). Conclusions. A fellowship training program can prepare physician investigators for research careers that bridge the divide between medicine and public health. PMID:22594745

  1. Training physician investigators in medicine and public health research.

    PubMed

    Gourevitch, Marc N; Jay, Melanie R; Goldfrank, Lewis R; Mendelsohn, Alan L; Dreyer, Benard P; Foltin, George L; Lipkin, Mack; Schwartz, Mark D

    2012-07-01

    We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health. We developed a rigorous curriculum in public health content and research methods and fostered linkages with research mentors and local public health agencies. Didactic training provided the foundation for fellows' mentored research initiatives, which addressed real-world challenges in advancing the health status of vulnerable urban populations. Two multidisciplinary cohorts (6 per cohort) completed this 2-year degree-granting program and engaged in diverse public health research initiatives on topics such as improving pediatric care outcomes through health literacy interventions, reducing hospital readmission rates among urban poor with multiple comorbidities, increasing cancer screening uptake, and broadening the reach of addiction screening and intervention. The majority of fellows (10/12) published their fellowship work and currently have a career focused in public health-related research or practice (9/12). A fellowship training program can prepare physician investigators for research careers that bridge the divide between medicine and public health.

  2. Perspectives of public health laboratories in emerging infectious diseases.

    PubMed

    Chua, Kaw Bing; Gubler, Duane J

    2013-06-01

    The world has experienced an increased incidence and transboundary spread of emerging infectious diseases over the last four decades. We divided emerging infectious diseases into four categories, with subcategories in categories 1 and 4. The categorization was based on the nature and characteristics of pathogens or infectious agents causing the emerging infections, which are directly related to the mechanisms and patterns of infectious disease emergence. The factors or combinations of factors contributing to the emergence of these pathogens vary within each category. We also classified public health laboratories into three types based on function, namely, research, reference and analytical diagnostic laboratories, with the last category being subclassified into primary (community-based) public health and clinical (medical) analytical diagnostic laboratories. The frontline/leading and/or supportive roles to be adopted by each type of public health laboratory for optimal performance to establish the correct etiological agents causing the diseases or outbreaks vary with respect to each category of emerging infectious diseases. We emphasize the need, especially for an outbreak investigation, to establish a harmonized and coordinated national public health laboratory system that integrates different categories of public health laboratories within a country and that is closely linked to the national public health delivery system and regional and international high-end laboratories.

  3. Perspectives of public health laboratories in emerging infectious diseases

    PubMed Central

    Chua, Kaw Bing; Gubler, Duane J

    2013-01-01

    The world has experienced an increased incidence and transboundary spread of emerging infectious diseases over the last four decades. We divided emerging infectious diseases into four categories, with subcategories in categories 1 and 4. The categorization was based on the nature and characteristics of pathogens or infectious agents causing the emerging infections, which are directly related to the mechanisms and patterns of infectious disease emergence. The factors or combinations of factors contributing to the emergence of these pathogens vary within each category. We also classified public health laboratories into three types based on function, namely, research, reference and analytical diagnostic laboratories, with the last category being subclassified into primary (community-based) public health and clinical (medical) analytical diagnostic laboratories. The frontline/leading and/or supportive roles to be adopted by each type of public health laboratory for optimal performance to establish the correct etiological agents causing the diseases or outbreaks vary with respect to each category of emerging infectious diseases. We emphasize the need, especially for an outbreak investigation, to establish a harmonized and coordinated national public health laboratory system that integrates different categories of public health laboratories within a country and that is closely linked to the national public health delivery system and regional and international high-end laboratories. PMID:26038473

  4. Public Health System Research in Public Health Emergency Preparedness in the United States (2009–2015): Actionable Knowledge Base

    PubMed Central

    Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P.; Guicciardi, Stefano

    2017-01-01

    Background. In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. Objectives. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. Data Collection and Analysis. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Main Results. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across

  5. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    PubMed

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

  6. The Robert Wood Johnson Foundation Clinical Scholars Program and emergency medicine.

    PubMed

    Landman, Adam; Meisel, Zachary F

    2010-04-01

    Specialized research training for emergency physicians (EPs) may strengthen overall patient care through the development and improvement of clinical evidence in emergency care. One way an increasing number of emergency physicians have acquired these skills is through the Robert Wood Johnson Foundation Clinical Scholars Program (CSP), a 2-year fellowship that trains physicians to be leaders in improving health care. In addition to providing training in health policy and health services research, the CSP emphasizes the translation of research into action through leadership training, program development, and community-based participatory research. This article provides an in-depth look at the CSP and its impact on emergency medicine (EM). To date, 41 EPs have trained through the program, with increasing numbers in recent years. Graduates have gone on to become leaders in academia, public health, private industry, and foundations. Past and present EM-trained Clinical Scholars are working to find creative solutions for the challenges posed by the U.S. health care system and improve the delivery of emergency care. Emergency physicians who wish to conduct research or work with communities, organizations, practitioners, and policy-makers to address issues essential to the health and well-being of all Americans should consider the Robert Wood Johnson Foundation CSP.

  7. Executive summary: Education research in emergency medicine-opportunities, challenges, and strategies for success.

    PubMed

    LaMantia, Joseph; Deiorio, Nicole M; Yarris, Lalena M

    2012-12-01

    The 2012 Academic Emergency Medicine (AEM) consensus conference "Education Research In Emergency Medicine: Opportunities, Challenges, and Strategies for Success" convened a diverse group of stakeholders in medical education to target gaps in emergency medicine (EM) education research and identify priorities for future study. A total of 175 registrants collaborated in preparatory and conference-day activities to explore subtopics in educational interventions, learner assessment, faculty development, and research funding and infrastructure. The conference was punctuated by didactic sessions led by key international medical education experts and ended with consensus formation in many domains. This issue of AEM presents the exciting results of this process. © 2012 by the Society for Academic Emergency Medicine.

  8. Can Emergency Medicine Residents Predict Cost of Diagnostic Testing?

    PubMed Central

    Tainter, Christopher R.; Gentges, Joshua A.; Thomas, Stephen H.; Burns, Boyd D.

    2017-01-01

    Introduction Diagnostic testing represents a significant portion of healthcare spending, and cost should be considered when ordering such tests. Needless and excessive spending may occur without an appreciation of the impact on the larger healthcare system. Knowledge regarding the cost of diagnostic testing among emergency medicine (EM) residents has not previously been studied. Methods A survey was administered to 20 EM residents from a single ACGME-accredited three-year EM residency program, asking for an estimation of patient charges for 20 commonly ordered laboratory tests and seven radiological exams. We compared responses between residency classes to evaluate whether there was a difference based on level of training. Results The survey completion rate was 100% (20/20 residents). We noted significant discrepancies between the median resident estimates and actual charge to patient for both laboratory and radiological exams. Nearly all responses were an underestimate of the actual cost. The group median underestimation for laboratory testing was $114, for radiographs $57, and for computed tomography exams was $1,058. There was improvement in accuracy with increasing level of training. Conclusion This pilot study demonstrates that EM residents have a poor understanding of the charges burdening patients and health insurance providers. In order to make balanced decisions with regard to diagnostic testing, providers must appreciate these factors. Education regarding the cost of providing emergency care is a potential area for improvement of EM residency curricula, and warrants further attention and investigation. PMID:28116030

  9. Policy perspectives on the emerging pathways of personalized medicine

    PubMed Central

    Downing, Gregory J.

    2009-01-01

    Remarkable advances in the fundamental knowledge about the biological basis of disease and technical advances in methods to assess genomic information have led the health care system to the threshold of personalized medicine. It is now feasible to consider strategic application of genomic information to guide patient management by being predictive, preemptive, and preventive, and enabling patient participation in medical decisions. Early evidence of this transition has some hallmarks of disruptive innovation to existing health care practices. Presented here is an examination of the changes underway to enable this new concept in health care in the United States, to improve precision and quality of care through innovations aimed at individualized approaches to medical decision making. A broad range of public policy positions will need to be considered for the health care delivery enterprise to accommodate the promise of this new science and technology for the benefit of patients. PMID:20135895

  10. Public engagement workshop: how to improve medicines for older people?

    PubMed

    Orlu-Gul, Mine; Raimi-Abraham, Bahijja; Jamieson, Elizabeth; Wei, Li; Murray, Macey; Stawarz, Katarzyna; Stegemann, Sven; Tuleu, Catherine; Smith, Felicity J

    2014-01-01

    Public engagement in medication management has become more and more important in promoting population health. A public engagement workshop attended by 78 members of the geriatric community, family carers as well as professionals from academic research, industry and regulatory agencies entitled 'How to improve medicines for older people?' took place on the 2nd July 2013 at the University College London (UCL) School of Pharmacy. The main aim of the event was to provide a dynamic environment for information exchange and to identify ways of improving current and future geriatric drug therapy. The day opened with presentations from UCL School of Pharmacy researchers on the use of medicines at home, formulations, administration devices and multi-component compliance aids (MCAs) whilst a representative from UCL Interaction Centre gave an insightful presentation on human errors and resilience strategies regarding medication use. These opening presentations encouraged participants to share their own experiences as well as initiating a lively debate. Following the plenary presentations, the workshop was divided into 8 groups for parallel discussion session. These opinion sharing sessions witnessed fruitful discussions between patients, carers and researchers. The day closed with a panel session of representatives from the European Medicines Agency (EMA), the Medicines and Healthcare products Regulatory Agency (MHRA), the Geriatric Medicines Society and Guy's and St. Thomas' NHS Foundation Trust (GSTT). Participants were encouraged to voice their questions, concerns and recommendations about medications. The main concern expressed by both patients and carers from the workshop were (but are not limited to) formulation changes, MCA accessibility difficulties, interactions of different medicines, carers' concerns with the administration of medicines and not having enough knowledge of services provided by community pharmacists i.e. medicines use reviews (MURs) or new medicine

  11. 21 CFR 25.16 - Public health and safety emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Public health and safety emergencies. 25.16 Section 25.16 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health...

  12. 21 CFR 25.16 - Public health and safety emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Public health and safety emergencies. 25.16 Section 25.16 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public...

  13. Integrative Medicine Selects Best Practice from Public Health and Biomedicine

    PubMed Central

    Ryan, Terence J

    2013-01-01

    The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803

  14. Integrative medicine selects best practice from public health and biomedicine.

    PubMed

    Ryan, Terence J

    2013-03-01

    The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice.

  15. Global emergency medicine journal club: social media responses to the march 2014 annals of emergency medicine journal club on targeted temperature management.

    PubMed

    Thoma, Brent; Rolston, Daniel; Lin, Michelle

    2014-08-01

    In March 2014, Annals of Emergency Medicine continued a successful collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host another Global Emergency Medicine Journal Club session featuring the 2013 New England Journal of Medicine article "Targeted Temperature Management at 33°C (91.4°F) Versus 36°C (96.8°F) After Cardiac Arrest" by Nielsen et al. This online journal club used Twitter conversations, a live videocast with the authors, and detailed discussions on the ALiEM Web site's comment section. This summary article details the community discussion, shared insights, and analytic data generated using this novel, multiplatform approach. Copyright © 2014 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  16. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    PubMed Central

    2012-01-01

    Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness

  17. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    PubMed

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  18. Public-Medicine Dissonance: Why in a World of Evidence-based Medicine?

    PubMed

    Gordon, Michael

    2015-10-26

    The evolution of medicine is quite remarkable and astounding. Modern medicine is successfully treating or providing long-term control of conditions which in the not-so-distant past were lethal or resulted in permanent disability. The strong emphasis on evidence-based medicine in today's medical profession has led to a more organized approach toward evaluating the safety and efficacy of new medical treatments. Despite attempts to meet the complex needs of an ever-aging population, an almost cynical or inherent distrust of physicians in general and their medical claims is being increasingly noted. For many physicians this has led to an uncomfortable sense of professional frustration as doubt is cast on themselves or the medical profession in general when the expectations and goals of patients or their families are not achieved. The causes of this apparent malady of contemporary medicine are myriad and may be explored from various perspectives, depending on the particular issue. To understand better the issues and challenges involved, today's medical practitioner needs to be aware of the complex mix of organizational, professional, ethical, and at times anthropological perspectives contributing to this dissonance between medical professionals and the public. Improving our insight into the forces at work in this dissonance will help medical professionals improve medical services to the public and contribute to the preservation of medicine's admirable historical legacy.

  19. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology.

    PubMed Central

    Touquet, R.; Driscoll, P.; Nicholson, D.

    1995-01-01

    One of the many attractions of accident and emergency medicine is the wide and varied opportunities it provides for education. This is because of the acute nature of the work, which necessitates prompt and accurate decision making. However, in many instances the decisions have to be made by inexperienced senior house officers. Departments therefore need a safe system of practice that can be remembered and adhered to under stress. The 10 commandments is one such system for analysing emergency radiographs of all the regions of the body. This system lays down guidelines to protect both staff and hospitals from the inevitable mistakes that inexperienced doctors will make. Images FIG 1 FIG 2 FIG 3 PMID:7661941

  20. Military Medicine Publications: What has Happened in the Past Two Decades?

    PubMed

    Yavnai, Nirit; Huerta-Hartal, Michael; Mimouni, Francis; Pinkert, Moshe; Dagan, David; Kreiss, Yitshak

    2014-05-28

    Military medical personnel, like all other physician specialists, face the challenge of keeping updated with developments in their field of expertise, in view of the great amount of new medical information published in the literature. The availability of the Internet has triggered tremendous changes in publication characteristics, and in some fields, the number of publications has increased substantially. The emergence of electronic open access journals and the improvement in Web search engines has triggered a significant change in the publication processes and in accessibility of information. The objective of this study was to characterize the temporal trends in the number and types of publications in military medicine in the medical literature. We searched all PubMed-registered publications from January 1, 1990 to December 31, 2010 using the keywords "military" or "army". We used the publication tag in PubMed to identify and examine major publication types. The trends were tested using the Mann-Kendall test for trend. Our search yielded 44,443 publications in military medicine during the evaluation period. Overall, the number of publications showed two distinct phases over time: (1) a moderate increase from 1990 to 2001 with a mean annual increase of 2.78% (r(2)=.79, P<.002), and (2) a steeper mean annual increase of 11.20% (r(2)=.96, P<.002) from 2002 to 2010. Most of the examined publication types showed a similar pattern. The proportion of high-quality-of-evidence publication types (randomized controlled trials, systematic reviews, and meta-analyses) increased from 2.91% to 8.43% of the overall military medicine publications with a mean annual incremental increase of 14.20%. These publication types demonstrated a similar dual phase pattern of increase (10.01%, r(2)=.80, P<.002 for 1990-2001 and 20.66%, r(2)=.88, P<.002 for 2002-2010). We conclude that over the past twenty years, scholarly work in the field of military medicine has shown a significant increase

  1. Emergency Medicine Resident Assessment of the Emergency Ultrasound Milestones and Current Training Recommendations.

    PubMed

    Stolz, Lori A; Stolz, Uwe; Fields, J Matthew; Saul, Turandot; Secko, Michael; Flannigan, Matthew J; Sheele, Johnathan M; Rifenburg, Robert P; Weekes, Anthony J; Josephson, Elaine B; Bedolla, John; Resop, Dana M; Dela Cruz, Jonathan; Boysen-Osborn, Megan; Caffery, Terrell; Derr, Charlotte; Bengiamin, Rimon; Chiricolo, Gerardo; Backlund, Brandon; Heer, Jagdipak; Hyde, Robert J; Adhikari, Srikar

    2017-03-01

    Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training, which includes demonstration of procedural competency in bedside ultrasound. The objective of this study was to assess EM residents' use of ultrasound and perceptions of the proposed ultrasound milestones and guidelines for assessment. This study is a prospective stratified cluster sample survey of all U.S. EM residency programs. Programs were stratified based on their geographic location (Northeast, South, Midwest, West), presence/absence of ultrasound fellowship program, and size of residency with programs sampled randomly from each stratum. The survey was reviewed by experts in the field and pilot tested on EM residents. Summary statistics and 95% confidence intervals account for the survey design, with sampling weights equal to the inverse of the probability of selection, and represent national estimates of all EM residents. There were 539 participants from 18 residency programs with an overall survey response rate of 85.1%. EM residents considered several applications to be core applications that were not considered core applications by CORD-AEUS (quantitative bladder volume, diagnosis of joint effusion, interstitial lung fluid, peritonsillar abscess, fetal presentation, and gestational age estimation). Of several core and advanced applications, the Focused Assessment with Sonography in Trauma examination, vascular access, diagnosis of pericardial effusion, and cardiac standstill were considered the most likely to be used in future clinical practice. Residents responded that procedural guidance would be more crucial to

  2. Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

    PubMed

    Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

    2010-02-01

    Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study.

    PubMed

    Asish, K; Suresh, Varun

    2016-02-01

    Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs), presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected. The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI), separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

  4. Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

    PubMed Central

    Asish, K; Suresh, Varun

    2016-01-01

    Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs), presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected. The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI), separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians. PMID:27013749

  5. Veterinary medicine protecting and promoting the public's health and well-being.

    PubMed

    Pappaioanou, Marguerite

    2004-03-16

    Dr. Calvin Schwabe's vision of "One Medicine" has long inspired many in the public health community to strive toward bringing human and veterinary medicine together to improve the public's health and well-being around the world. In an increasingly human-dominated world, as Dr. Schwabe suggested many years ago, human health provides the most-logical unifying or apical cause in veterinary medicine's hierarchy of values. Veterinarians in all aspects of the profession-have opportunity and responsibility to protect the health and well-being of people in all that they do, including protecting food security and safety; addressing threats to antibiotic sensitivity; preventing and controlling zoonotic emerging infectious diseases; protecting environments and ecosystems; participating in bio- and agro-terrorism preparedness and response; using their skills to confront non-zoonotic diseases (such as malaria, HIV/AIDS, vaccine preventable diseases, chronic diseases and injuries); strengthening the public-health infrastructure; and advancing medical science through research. This article provides an overview of contributions made by veterinarians in each of these areas, and discusses the challenges to be overcome and the need for strategic thinking and action to achieve the vision of "one medicine".

  6. Approaches to patient health information exchange and their impact on emergency medicine.

    PubMed

    Shapiro, Jason S; Kannry, Joseph; Lipton, Mark; Goldberg, Eric; Conocenti, Paul; Stuard, Susan; Wyatt, Brian M; Kuperman, Gilad

    2006-10-01

    Regional health information organizations and electronic health information exchange may have an important impact on the practice of emergency medicine in the United States. Regional health information organizations are local or regional information-sharing networks that enable electronic data interchange among stakeholders in a given geographic area. These stakeholders may include hospitals, skilled nursing facilities, clinics, private physicians' offices, pharmacies, laboratories, radiology facilities, health departments, payers, and possibly the patients themselves. Regional health information organizations are being formed across the country to improve the safety and efficiency of clinical care; improve public health efforts, biosurveillance, and disaster management response; and potentially create large databases of deidentified aggregate data for research. Because of the unique need for rapid access to information and the acuity of the clinical environment, few areas of the health care delivery system stand to change and benefit more from health information exchange than our nation's emergency departments. This article will explain the motivation for the development of regional health information organizations, identify some of the important issues in their formation, and discuss how their development might affect the practice of emergency medicine.

  7. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review.

    PubMed

    Dubé, Laurent; Granry, Jean-Claude

    2003-01-01

    To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine. References were obtained from Medline(R) (1995 to 2002). All categories of articles (clinical trials, reviews, or meta-analyses) on this topic were selected. The key words used were magnesium, anesthesia, analgesia, emergency medicine, intensive care, surgery, physiology, pharmacology, eclampsia, pheochromocytoma, asthma, and acute myocardial infarction. Hypomagnesemia is frequent postoperatively and in the intensive care and needs to be detected and corrected to prevent increased morbidity and mortality. Magnesium reduces catecholamine release and thus allows better control of adrenergic response during intubation or pheochromocytoma surgery. It also decreases the frequency of postoperative rhythm disorders in cardiac surgery as well as convulsive seizures in preeclampsia and their recurrence in eclampsia. The use of adjuvant magnesium during perioperative analgesia may be beneficial for its antagonist effects on N-methyl-D-aspartate receptors. The precise role of magnesium in the treatment of asthmatic attacks and myocardial infarction in emergency conditions needs to be determined. Magnesium has many known indications in anesthesiology and intensive care, and others have been suggested by recent publications. Because of its interactions with drugs used in anesthesia, anesthesiologists and intensive care specialists need to have a clear understanding of the role of this important cation.

  8. Emerging infections: a tribute to the one medicine, one health concept.

    PubMed

    Kahn, R E; Clouser, D F; Richt, J A

    2009-08-01

    Events in the last decade have taught us that we are now, more than ever, vulnerable to fatal zoonotic diseases such as those caused by haemorrhagic fever viruses, influenza, rabies and BSE/vCJD. Future research activities should focus on solutions to these problems arising at the interface between animals and humans. A 4-fold classification of emerging zoonoses was proposed: Type 1: from wild animals to humans (Hanta); Type 1 plus: from wild animals to humans with further human-to-human transmission (AIDS); Type 2: from wild animals to domestic animals to humans (Avian flu) and Type 2 plus: from wild animals to domestic animals to humans, with further human-to-human transmission (Severe Acute Respiratory Syndrome, SARS). The resulting holistic approach to emerging infections links microbiology, veterinary medicine, human medicine, ecology, public health and epidemiology. As emerging 'new' respiratory viruses are identified in many wild and domestic animals, issues of interspecies transmission have become of increasing concern. The development of safe and effective human and veterinary vaccines is a priority. For example, the spread of different influenza viruses has stimulated influenza vaccine development, just as the spread of Ebola and Marburg viruses has led to new approaches to filovirus vaccines. Interdisciplinary collaboration has become essential because of the convergence of human disease, animal disease and a common approach to biosecurity. High containment pathogens pose a significant threat to public health systems, as well as a major research challenge, because of limited experience in case management, lack of appropriate resources in affected areas and a limited number of animal research facilities in developed countries. Animal models that mimic certain diseases are key elements for understanding the underlying mechanisms of disease pathogenesis, as well as for the development and efficacy testing of therapeutics and vaccines. An updated veterinary

  9. Environmental hazards and public health: lessons for the practice of medicine and for public policy

    SciTech Connect

    Wedeen, R.P.; Sheehan, H.E. )

    1992-01-01

    The separation of occupational and environmental disease from the mainstream of medical practice has deep roots in the culture of the profession. Medical practice centered on individual patient care as nineteenth-century science yielded the therapeutic triumphs of the twentieth century. Social issues seemed remote to medical practitioners as the rewards of scientifically based therapies upstaged the unglamorous aspects of preventive medicine. Public health was left to politicians and bureaucrats. Victorian ambivalence toward the less successful members of society reinforced the isolation of medicine from public policy. As a consequence, physicians are largely ignored in contemporary debates about environmental hazards, to the detriment of both society and the profession.

  10. Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.

    PubMed

    McRobert, Allistair Paul; Causer, Joe; Vassiliadis, John; Watterson, Leonie; Kwan, James; Williams, Mark A

    2013-06-01

    It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients' symptoms resulting in higher diagnostic accuracy. Our findings have implications for scenario design and the manipulation of contextual information during simulation training.

  11. State of Emergency Medicine in Switzerland: a national profile of emergency departments in 2006

    PubMed Central

    2013-01-01

    Background Emergency departments (EDs) are an essential component of any developed health care system. There is, however, no national description of EDs in Switzerland. Our objective was to establish the number and location of EDs, patient visits and flow, medical staff and organization, and capabilities in 2006, as a benchmark before emergency medicine became a subspecialty in Switzerland. Methods In 2007, we started to create an inventory of all hospital-based EDs with a preliminary list from the Swiss Society of Emergency and Rescue Medicine that was improved with input from ED physicians nationwide. EDs were eligible if they offered acute care 24 h per day, 7 days per week. Our goal was to have 2006 data from at least 80% of all EDs. The survey was initiated in 2007 and the 80% threshold reached in 2012. Results In 2006, Switzerland had a total of 138 hospital-based EDs. The number of ED visits was 1.475 million visits or 20 visits per 100 inhabitants. The median number of visits was 8,806 per year; 25% of EDs admitted 5,000 patients or less, 31% 5,001-10,000 patients, 26% 10,001-20,000 patients, and 17% >20,000 patients per year. Crowding was reported by 84% of EDs with >20,000 visits/year. Residents with limited experience provided care for 77% of visits. Imaging was not immediately available for all patients: standard X-ray within 15 min (70%), non-contrast head CT scan within 15 min (38%), and focused sonography for trauma (70%); 67% of EDs had an intensive care unit within the hospital, and 87% had an operating room always available. Conclusions Swiss EDs were significant providers of health care in 2006. Crowding, physicians with limited experience, and the heterogeneity of emergency care capabilities were likely threats to the ubiquitous and consistent delivery of quality emergency care, particularly for time-sensitive conditions. Our survey establishes a benchmark to better understand future improvements in Swiss emergency care. PMID:23842482

  12. Training in Urban Medicine and Public Health: TRIUMPH.

    PubMed

    Haq, Cynthia; Stearns, Marjorie; Brill, John; Crouse, Byron; Foertsch, Julie; Knox, Kjersti; Stearns, Jeffrey; Skochelak, Susan; Golden, Robert N

    2013-03-01

    The number of U.S. medical school graduates who choose to practice in health professional shortage areas (HPSAs) has not kept pace with the needs of society. The University of Wisconsin School of Medicine and Public Health has created a new program that prepares medical students to reduce health disparities for urban medically underserved populations in Milwaukee. The authors describe the Training in Urban Medicine and Public Health (TRIUMPH) program and provide early, short-term outcomes. TRIUMPH integrates urban clinical training, community and public health curricula, longitudinal community and public health projects, mentoring, and peer support for select third- and fourth-year medical students. The authors tracked and held focus groups with program participants to assess their knowledge, skills, satisfaction, confidence, and residency matches. The authors surveyed community partners to assess their satisfaction with students and the program. From 2009 to 2012, 53 students enrolled in the program, and 45 have conducted projects with community organizations. Participants increased their knowledge, skills, confidence, and commitment to work with urban medically underserved populations. Compared with local peers, TRIUMPH graduates were more likely to select primary care specialties and residency programs serving urban underserved populations. Community leaders have reported high levels of satisfaction and benefits; their interest in hosting students exceeds program capacity. Early, short-term outcomes confirm that TRIUMPH is achieving its desired goals: attracting and preparing medical students to work with urban underserved communities. The program serves as a model to prepare physicians to meet the needs of urban HPSAs.

  13. Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

    PubMed Central

    Neri, P.M.; Redden, L.; Poole, S.; Pozner, C.N.; Horsky, J.; Raja, A.S.; Poon, E.; Schiff, G.

    2015-01-01

    Summary Objective To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. Methods We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Results Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. Conclusion We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to

  14. Workplace Violence and Harassment Against Emergency Medicine Residents

    PubMed Central

    Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

    2016-01-01

    Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

  15. Communicating the threat of emerging infections to the public.

    PubMed

    Freimuth, V; Linnan, H W; Potter, P

    2000-01-01

    Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health.

  16. Communicating the threat of emerging infections to the public.

    PubMed Central

    Freimuth, V.; Linnan, H. W.; Potter, P.

    2000-01-01

    Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health. PMID:10905966

  17. Nurses' beliefs about public health emergencies: fear of abandonment.

    PubMed

    O'Boyle, Carol; Robertson, Cheryl; Secor-Turner, Molly

    2006-08-01

    Since the events of September 11, 2001, subsequent anthrax mailings, world political events, and natural disasters such as Hurricane Katrina and the recent tsunami, public health emergencies including bioterrorism events are viewed as realistic possibilities. Public health emergencies would stress the current health care system. The objective was to identify beliefs and concerns of nurses who work in hospitals designated as receiving sites during public health emergencies. A qualitative study using focus groups with a total of 33 hospital nurses in 2003 was used. Audiotapes were analyzed, and codes, categories, and a theme were identified. Fear of abandonment was the overarching theme. Nurses believed that clinical settings would be chaotic, without a clear chain of command, and with some colleagues refusing to work. Limited access to personal protective equipment, risk of infection, unmanageable numbers of patients, and possibly being assaulted for their personal protective equipment resulted in the sense that they would be in unsafe clinical environments. Loss of freedom to leave the hospital and fears that hospitals would not provide treatment to nurses who become ill as a result of caring for patients contributed to the sense of abandonment. Although these nurses worked in hospitals with comprehensive public health emergency plans, they believed that they would not have readily accessible material and human resources to cope with a bioterrorism event. Readiness plans should include a systematic assessment of nurses' concerns. Health care readiness plans should incorporate focused interventions to improve safety, a sense of control, and facilitate coping in public health emergencies.

  18. Public-private partnerships as driving forces in the quest for innovative medicines.

    PubMed

    Goldman, Michel; Compton, Carolyn; Mittleman, Barbara B

    2013-01-15

    Despite progress in translational research, we are still falling short in developing the innovative medicines required to address major public health needs. Furthermore, the failure rate, time, and cost required for registration of a new drug are pushing the economics of the industry to the breaking point. New models of drug development based on collaborative endeavours are badly needed to improve this dire situation. In 2004, the US Food and Drug Administration (FDA) introduced the Critical Path Initiative with the intent of modernizing drug development by implementing public-private partnerships (PPP) to share data, expertise, and resources. In response to FDA's initiative, in the following year the non-profit Critical Path Institute (C-Path) was formed. At the same time, the National Institutes of Health (NIH) Public-Private Partnership program was established. In Europe, the Innovative Medicines Initiative (IMI) supported jointly by the European Union and the European Federation of Pharmaceutical Industries and Associations was launched in 2008. These independent efforts have a common long-term objective, namely to facilitate the emergence of innovative medicines by developing new tools for drug discovery, new indicators for drug efficacy or safety, and new approaches for patient stratification. Herein, we present evidence that PPP already exert a positive impact on the drug development process. Public-private partnerships represent attractive means to leverage resources dispersed across industry, academia, and voluntary health organizations in order to address multiple challenges of drug development in an era of constrained resources and increased regulatory pressure.

  19. The Research Component in the Development of Emergency Medicine as a Specialty

    ERIC Educational Resources Information Center

    Anwar, Rebecca A. H.; Wagner, David K.

    1977-01-01

    An example of a methodology for programmatic research development in emergency medicine is identified through the establishment of a nonclinical health services research position, which contributes to building a body of knowledge specific to emergency medicine and creating a sense of professional identity among graduate trainees. (Author/LBH)

  20. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    ERIC Educational Resources Information Center

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  1. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    ERIC Educational Resources Information Center

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  2. A Needs Assessment for a Longitudinal Emergency Medicine Intern Curriculum.

    PubMed

    Shappell, Eric; Ahn, James

    2017-01-01

    A key task of emergency medicine (EM) training programs is to develop a consistent knowledge of core content in recruits with heterogeneous training backgrounds. The traditional model for delivering core content is lecture-based weekly conference; however, a growing body of literature finds this format less effective and less appealing than alternatives. We sought to address this challenge by conducting a needs assessment for a longitudinal intern curriculum for millennial learners. We surveyed all residents from the six EM programs in the greater Chicago area regarding the concept, format, and scope of a longitudinal intern curriculum. We received 153 responses from the 300 residents surveyed (51% response rate). The majority of respondents (80%; 82% of interns) agreed or strongly agreed that a dedicated intern curriculum would add value to residency education. The most positively rated teaching method was simulation sessions (91% positive responses), followed by dedicated weekly conference time (75% positive responses) and dedicated asynchronous resources (71% positive responses). Less than half of respondents (47%; 26% of interns) supported use of textbook readings in the curriculum. There is strong learner interest in a longitudinal intern curriculum. This needs assessment can serve to inform the development of a universal intern curriculum targeting the millennial generation.

  3. Importance of residency program web sites to emergency medicine applicants.

    PubMed

    Mahler, Simon A; Wagner, Mary-Jo; Church, Amy; Sokolosky, Mitchell; Cline, David M

    2009-01-01

    Emergency Medicine (EM) residency program web sites are an important tool that programs use to attract applicants. However, there are only a few studies examining the aspects of a program's web site that are most important to EM applicants. We conducted a cross-sectional study of 142 prospective residency applicants interviewing for an EM position at one of three EM residency programs for the 2003 match. The survey demonstrated that almost all applicants researched EM programs online. The majority (71%) identified geographic location as the most important factor in applying to a specific program. Approximately 40% considered an easily navigated web site as very/moderately important to their application decision-making process. Rotation schedule was also important in applicant decision-making. The Internet is a significant source of information to the majority of applicants in EM. Online information from programs' web sites, although not as significant as geography, influences an applicant's choice of where to apply for a residency position. An easily navigated, complete web site may improve the recruitment of candidates to EM residency programs.

  4. A Needs Assessment for a Longitudinal Emergency Medicine Intern Curriculum

    PubMed Central

    Shappell, Eric; Ahn, James

    2017-01-01

    Introduction A key task of emergency medicine (EM) training programs is to develop a consistent knowledge of core content in recruits with heterogeneous training backgrounds. The traditional model for delivering core content is lecture-based weekly conference; however, a growing body of literature finds this format less effective and less appealing than alternatives. We sought to address this challenge by conducting a needs assessment for a longitudinal intern curriculum for millennial learners. Methods We surveyed all residents from the six EM programs in the greater Chicago area regarding the concept, format, and scope of a longitudinal intern curriculum. Results We received 153 responses from the 300 residents surveyed (51% response rate). The majority of respondents (80%; 82% of interns) agreed or strongly agreed that a dedicated intern curriculum would add value to residency education. The most positively rated teaching method was simulation sessions (91% positive responses), followed by dedicated weekly conference time (75% positive responses) and dedicated asynchronous resources (71% positive responses). Less than half of respondents (47%; 26% of interns) supported use of textbook readings in the curriculum. Conclusion There is strong learner interest in a longitudinal intern curriculum. This needs assessment can serve to inform the development of a universal intern curriculum targeting the millennial generation. PMID:28116005

  5. Performance criteria for emergency medicine residents: a job analysis.

    PubMed

    Blouin, Danielle; Dagnone, Jeffrey Damon

    2008-11-01

    A major role of admission interviews is to assess a candidate's suitability for a residency program. Structured interviews have greater reliability and validity than do unstructured ones. The development of content for a structured interview is typically based on the dimensions of performance that are perceived as important to succeed in a particular line of work. A formal job analysis is normally conducted to determine these dimensions. The dimensions essential to succeed as an emergency medicine (EM) resident have not yet been studied. We aimed to analyze the work of EM residents to determine these essential dimensions. The "critical incident technique" was used to generate scenarios of poor and excellent resident performance. Two reviewers independently read each scenario and labelled the performance dimensions that were reflected in each. All labels assigned to a particular scenario were pooled and reviewed again until a consensus was reached. Five faculty members (25% of our total faculty) comprised the subject experts. Fifty-one incidents were generated and 50 different labels were applied. Eleven dimensions of performance applied to at least 5 incidents. "Professionalism" was the most valued performance dimension, represented in 56% of the incidents, followed by "self-confidence" (22%), "experience" (20%) and "knowledge" (20%). "Professionalism," "self-confidence," "experience" and "knowledge" were identified as the performance dimensions essential to succeed as an EM resident based on our formal job analysis using the critical incident technique. Performing a formal job analysis may assist training program directors with developing admission interviews.

  6. Are there too few women presenting at emergency medicine conferences?

    PubMed

    Carley, Simon; Carden, Richard; Riley, Rebecca; May, Natalie; Hruska, Katrin; Beardsell, Iain; Johnston, Michelle; Body, Richard

    2016-10-01

    There is a perception that women are under-represented as speakers at emergency medicine (EM) conferences. We aimed to evaluate the ratio of male to female speakers and the proportion of presenting time by gender at major international EM conferences. Conference programmes of the major English-speaking EM conferences occurring from 2014 to 2015 were obtained. The number of presentations, the gender of the speaker and the duration of each presentation were recorded. We analysed eight major EM conferences. These included 2382 presentations, of which 29.9% (range 22.5%-40.9%) were given by women. In total, 56 104 min of presentations were analysed, of which 27.6% (range 21%-36.7%) were delivered by women. On average, presentations by women were 95 s shorter than presentations by men (23 vs 21 min 25 s). Male speakers exceed female speakers at major EM conferences. The reasons for this imbalance are likely complex and multifactorial and may reflect the gender imbalance within the specialty. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. The emerging agenda of stratified medicine in neurology.

    PubMed

    Matthews, Paul M; Edison, Paul; Geraghty, Olivia C; Johnson, Michael R

    2014-01-01

    Stratified medicine can reduce the costs of neurological care, bringing benefits to both patients and physicians. The availability of routine genetic testing, new biomarkers and advanced imaging, as well as new technologies for patient-centred data collection, has expanded the potential for patient stratification. Several neurology subspecialities, including stroke, epilepsy and behavioural neurology, have already applied stratification for disease prognosis, optimization of disease management and reduction of treatment-related adverse events. Stratification approaches could improve the cost-effectiveness of neurological care that involves treatments with high costs or risks of adverse reactions, as well as guide the use of emerging, highly individualized therapies. There are still major challenges in the development of clinically actionable stratification concepts, and practical barriers can limit adoption of these concepts into clinical practice. However, improved technologies and disease understanding are making more precise stratification practical. We believe that neurologists should become leaders in the development and validation of these practices, and that use of these approaches should be part of a broader strategy for addressing both the growing needs of an ageing population and the rising pressures for rapid improvements in the cost-effectiveness of therapeutics.

  8. Emergency Preparedness as Public Pedagogy: The Absent-Presence of Race in "Preparing for Emergencies"

    ERIC Educational Resources Information Center

    Preston, John; Avery, Barry; Chakrabarty, Namita; Edmonds, Casey

    2011-01-01

    Emergency preparedness can be considered to be a form of lifelong learning and public pedagogy with implications for race equality. The paper is based on an ESRC project "Preparedness pedagogies and race: an interdisciplinary approach" considering the policy process around the construction of the "Preparing for Emergencies"…

  9. Emergency Preparedness as Public Pedagogy: The Absent-Presence of Race in "Preparing for Emergencies"

    ERIC Educational Resources Information Center

    Preston, John; Avery, Barry; Chakrabarty, Namita; Edmonds, Casey

    2011-01-01

    Emergency preparedness can be considered to be a form of lifelong learning and public pedagogy with implications for race equality. The paper is based on an ESRC project "Preparedness pedagogies and race: an interdisciplinary approach" considering the policy process around the construction of the "Preparing for Emergencies"…

  10. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    PubMed Central

    Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

    2013-01-01

    Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automation system. According to the etiology of the pneumothorax, study groups were arranged like spontaneous pneumothorax and traumatic pneumothorax. Results: 82.2% (n = 106) of patients were male and 17.8% (n = 23) of patients were female and mean age were 31.3 ± 20,2 (Minimum: 1, Maximum: 87). 68.2% (n = 88) of patients were spontaneous pneumothorax (61.36%, n=79 were primary spontaneous pneumothorax) and 31.8% (n = 41) of patients were traumatic pneumothorax (21.95% were iatrogenic pneumothorax). Main complaint is shortness of breath (52.3%, n=67) and 38% (n=49) of patients were smokers. Posteroanterior (PA) Chest X-Ray has been enough for 64.3% (n = 83) of the patients' diagnosis. Tube thoracostomy is applied to 84.5% (n = 109) of patients and surgery is applied to 9.3% (n = 12) of patients and 6.2% (n = 8) of patients were discharged with conservative treatment. Spontaneous pneumothorax showed statistically significant high recurrence compared with traumatic pneumothorax (P = 0.007). 4.65% of (n = 6) patients died. The average age of those who died (9.3 ± 19.9), statistically were significantly lower the mean age of living patients (32.4 ± 19.7) (t test, P = 0,006). 83.33% of the patients who died were neonatals and in the 0-1 years age group, and five of these patients were secondary spontaneous pneumothorax, and one of these patients were iatrogenic pneumothorax due to mechanical ventilation. Conclusions: Pneumothorax in adults can be treated by tube thoracostomy or

  11. Something for pain: Responsible opioid use in emergency medicine.

    PubMed

    Strayer, Reuben J; Motov, Sergey M; Nelson, Lewis S

    2017-02-01

    The United States is currently experiencing a public health crisis of opioid addiction, which has its genesis in an industry marketing effort that successfully encouraged clinicians to prescribe opioids liberally, and asserted the safety of prescribing opioids for chronic non-cancer pain, despite a preponderance of evidence demonstrating the risks of dependence and misuse. The resulting rise in opioid use has pushed drug overdose deaths in front of motor vehicle collisions to become the leading cause of accidental death in the country. Emergency providers frequently treat patients for complications of opioid abuse, and also manage patients with acute and chronic pain, for which opioids are routinely prescribed. Emergency providers are therefore well positioned to both prevent new cases of opioid misuse and initiate appropriate treatment of existing opioid addicts. In opioid-naive patients, this is accomplished by a careful consideration of the likelihood of benefit and harm of an opioid prescription for acute pain. If opioids are prescribed, the chance of harm is reduced by matching the number of pills prescribed to the expected duration of pain and selecting an opioid preparation with low abuse liability. Patients who present to acute care with exacerbations of chronic pain or painful conditions associated with opioid misuse are best managed by treating symptoms with opioid alternatives and encouraging treatment for opioid addiction.

  12. Selection of medicines in Chilean public hospitals: an exploratory study

    PubMed Central

    2013-01-01

    Background There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. Methods A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees). Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. Results The national survey had an overall response rate of 42% (83 out of 196), whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties. The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. Conclusions There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical needs of doctors, training

  13. Perception of Thromboembolism Risk: Differences between the Departments of Internal Medicine and Emergency Medicine.

    PubMed

    Vincentelli, Giovanni Maria; Monti, Manuel; Pirro, Maria Rosaria; Bertazzoni, Giuliano; Pugliese, Francesco Rocco; Ciammaichella, Maurizio; Ruggieri, Maria Pia; Landolfi, Raffaele

    2016-01-01

    The latest developments in emergency medicine (EM) have introduced new typologies of patients that have not been taken into account in previous studies of venous thromboembolism (VTE) risk. The aim of the current study was to evaluate by comparing the main international risk scores whether different perceptions of VTE risk exist in internal medicine (IM) departments and in EM departments. This cross-sectional observational study involved 23 IM and 10 EM departments of 21 different hospitals. The patient data were collected by physicians who were blinded to the purpose of the study. The data were analyzed using the main international risk scores. We analyzed 742 patients, 222 (30%) hospitalized in EM departments and the remaining 520 (70%) in IM departments. We found that fewer patients at risk for VTE were treated with low-molecular-weight heparin (LMWH) in EM departments than in IM departments. Moreover, there was significant statistical difference in the use of LMWH between IM and EM departments when the Padua score and immobilization criteria were used to assess the risk. The infrequent use of LMWH in EM patients may have several causes. For example, in EM departments, treatment of acute illness often takes higher priority than VTE risk evaluation. Moreover, immobilization criteria cannot be evaluated for all EM patients because of the intrinsic time requirements. For the aforementioned reasons, we believe that a different VTE risk score is required that takes into account the peculiarities of EM, and establishing such a score should be the object of future study.

  14. Case reports describing treatments in the emergency medicine literature: missing and misleading information

    PubMed Central

    Richason, Tiffany P; Paulson, Stephen M; Lowenstein, Steven R; Heard, Kennon J

    2009-01-01

    Background Although randomized trials and systematic reviews provide the "best evidence" for guiding medical practice, many emergency medicine journals still publish case reports (CRs). The quality of the reporting in these publications has not been assessed. Objectives In this study we sought to determine the proportion of treatment-related case reports that adequately reported information about the patient, disease, interventions, co-interventions, outcomes and other critical information. Methods We identified CRs published in 4 emergency medicine journals in 2000–2005 and categorized them according to their purpose (disease description, overdose or adverse drug reactioin, diagnostic test or treatment effect). Treatment-related CRs were reviewed for the presence or absence of 11 reporting elements. Results All told, 1,316 CRs were identified; of these, 85 (6.5%; 95CI = 66, 84) were about medical or surgical treatments. Most contained adequate descriptions of the patient (99%; 95CI = 95, 100), the stage and severity of the patient's disease (88%; 95CI = 79, 93), the intervention (80%; 95CI = 70, 87) and the outcomes of treatment (90%; 95CI = 82, 95). Fewer CRs reported the patient's co-morbidities (45%; 95CI = 35, 56), concurrent medications (30%; 95CI = 21, 40) or co-interventions (57%; 95CI = 46, 67) or mentioned any possible treatment side-effects (33%; 95CI = 24, 44). Only 37% (95CI = 19, 38) discussed alternative explanations for favorable outcomes. Generalizability of treatment effects to other patients was mentioned in only 29% (95CI = 20, 39). Just 2 CRs (2.3%; 95CI = 1, 8) reported a 'denominator" (number of patients subjected to the same intervention, whether or not successful. Conclusion Treatment-related CRs in emergency medicine journals often omit critical details about treatments, co-interventions, outcomes, generalizability, causality and denominators. As a result, the information may be misleading to providers, and the clinical applications may

  15. Public Health and Hospitals: a Common Area for Clinical and Public Health Medicine.

    PubMed

    Muzzi, A; Panà, A

    2017-01-01

    Contrary to what has happened so far, hospitals should become a setting which jointly exercise Clinical and Public Health Medicine. The areas of activity that require the presence of multidisciplinary teams and can bring benefits both to the patients and to the community is briefly described.

  16. Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.

    PubMed

    Carpenter, Christopher R; Bromley, Marilyn; Caterino, Jeffrey M; Chun, Audrey; Gerson, Lowell W; Greenspan, Jason; Hwang, Ula; John, David P; Lyons, William L; Platts-Mills, Timothy F; Mortensen, Betty; Ragsdale, Luna; Rosenberg, Mark; Wilber, Scott

    2014-07-01

    In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and strained healthcare systems. In response, geriatric emergency medicine clinicians, educators, and researchers collaborated with the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations, equipment, policies, and protocols. These Geriatric Emergency Department Guidelines represent the first formal society-led attempt to characterize the essential attributes of the geriatric ED and received formal approval from the boards of directors of each of the four societies in 2013 and 2014. This article is intended to introduce emergency medicine and geriatric healthcare providers to the guidelines while providing recommendations for continued refinement of these proposals through educational dissemination, formal effectiveness evaluations, cost-effectiveness studies, and eventually institutional credentialing.

  17. The great opportunity: Evolutionary applications to medicine and public health

    PubMed Central

    Nesse, Randolph M; Stearns, Stephen C

    2008-01-01

    Abstract Evolutionary biology is an essential basic science for medicine, but few doctors and medical researchers are familiar with its most relevant principles. Most medical schools have geneticists who understand evolution, but few have even one evolutionary biologist to suggest other possible applications. The canyon between evolutionary biology and medicine is wide. The question is whether they offer each other enough to make bridge building worthwhile. What benefits could be expected if evolution were brought fully to bear on the problems of medicine? How would studying medical problems advance evolutionary research? Do doctors need to learn evolution, or is it valuable mainly for researchers? What practical steps will promote the application of evolutionary biology in the areas of medicine where it offers the most? To address these questions, we review current and potential applications of evolutionary biology to medicine and public health. Some evolutionary technologies, such as population genetics, serial transfer production of live vaccines, and phylogenetic analysis, have been widely applied. Other areas, such as infectious disease and aging research, illustrate the dramatic recent progress made possible by evolutionary insights. In still other areas, such as epidemiology, psychiatry, and understanding the regulation of bodily defenses, applying evolutionary principles remains an open opportunity. In addition to the utility of specific applications, an evolutionary perspective fundamentally challenges the prevalent but fundamentally incorrect metaphor of the body as a machine designed by an engineer. Bodies are vulnerable to disease – and remarkably resilient – precisely because they are not machines built from a plan. They are, instead, bundles of compromises shaped by natural selection in small increments to maximize reproduction, not health. Understanding the body as a product of natural selection, not design, offers new research questions and a

  18. Using reality mining to improve public health and medicine.

    PubMed

    Pentland, Alex; Lazer, David; Brewer, Devon; Heibeck, Tracy

    2009-01-01

    We live our lives in digital networks. We wake up in the morning, check our e-mail, make a quick phone call, commute to work, buy lunch. Many of these transactions leave digital breadcrumbs--tiny records of our daily experiences. Reality mining, which pulls together these crumbs using statistical analysis and machine learning methods, offers an increasingly comprehensive picture of our lives, both individually and collectively, with the potential of transforming our understanding of ourselves, our organizations, and our society in a fashion that was barely conceivable just a few years ago. It is for this reason that reality mining was recently identified by Technology Review as one of "10 emerging technologies that could change the world". Many everyday devices provide the raw database upon which reality mining builds; sensors in mobile phones, cars, security cameras, RFID ('smart card') readers, and others, all allow for the measurement of human physical and social activity. Computational models based on such data have the potential to dramatically transform the arenas of both individual and community health. Reality mining can provide new opportunities with respect to diagnosis, patient and treatment monitoring, health services planning, surveillance of disease and risk factors, and public health investigation and disease control. Currently, the single most important source of reality mining data is the ubiquitous mobile phone. Every time a person uses a mobile phone, a few bits of information are left behind. The phone pings the nearest mobile-phone towers, revealing its location. The mobile phone service provider records the duration of the call and the number dialed. In the near future, mobile phones and other technologies will collect even more information about their users, recording everything from their physical activity to their conversational cadences. While such data pose a potential threat to individual privacy, they also offer great potential value

  19. Funding Public Health Emergency Preparedness in the United States.

    PubMed

    Katz, Rebecca; Attal-Juncqua, Aurelia; Fischer, Julie E

    2017-09-01

    The historical precedents that support state and local leadership in preparedness for and response to disasters are in many ways at odds with the technical demands of preparedness and response for incidents affecting public health. New and revised laws and regulations, executive orders, policies, strategies, and plans developed in response to biological threats since 2001 address the role of the federal government in the response to public health emergencies. However, financial mechanisms for disaster response-especially those that wait for gubernatorial request before federal assistance can be provided-do not align with the need to prevent the spread of infectious agents or efficiently reduce the impact on public health. We review key US policies and funding mechanisms relevant to public health emergencies and clarify how policies, regulations, and resources affect coordinated responses.

  20. Funding Public Health Emergency Preparedness in the United States

    PubMed Central

    Attal-Juncqua, Aurelia; Fischer, Julie E.

    2017-01-01

    The historical precedents that support state and local leadership in preparedness for and response to disasters are in many ways at odds with the technical demands of preparedness and response for incidents affecting public health. New and revised laws and regulations, executive orders, policies, strategies, and plans developed in response to biological threats since 2001 address the role of the federal government in the response to public health emergencies. However, financial mechanisms for disaster response—especially those that wait for gubernatorial request before federal assistance can be provided—do not align with the need to prevent the spread of infectious agents or efficiently reduce the impact on public health. We review key US policies and funding mechanisms relevant to public health emergencies and clarify how policies, regulations, and resources affect coordinated responses. PMID:28892446

  1. Applying educational gaming to public health workforce emergency preparedness.

    PubMed

    Barnett, Daniel J; Everly, George S; Parker, Cindy L; Links, Jonathan M

    2005-05-01

    From natural disasters to terrorism, the demands of public health emergency response require innovative public health workforce readiness training. This training should be competency-based yet flexible, and able to foster a culture of professional and personal readiness more traditionally seen in non-public health first-response agencies. Building on the successful applications of game-based models in other organizational development settings, the Johns Hopkins Center for Public Health Preparedness piloted the Road Map to Preparedness curriculum in 2003. Over 1500 employees at six health departments in Maryland have received training via this program through November 2004. Designed to assist public health departments in creating and implementing a readiness training plan for their workforce, the Road Map to Preparedness uses the core competencies of the Centers for Disease Control and Prevention for all public health workers as its basic framework.

  2. Perspectives of South American physicians hosting foreign rotators in emergency medicine

    PubMed Central

    2014-01-01

    of IHEs in Emergency Medicine from the perspective of physician hosts in several hospitals in South America. Our results suggest that IHEs function best when EM residents rotate later in residency training and when relationships are maintained and deepened among those involved including host physicians, rotators, and institutions. This leads to future rotators, project collaboration, research, and publications which not only benefit individuals involved but also the wider field of Emergency Medicine. PMID:25635188

  3. Perspectives of South American physicians hosting foreign rotators in emergency medicine.

    PubMed

    O'Donnell, Steve; Adler, David H; Inboriboon, Pholaphat Charles; Alvarado, Hermenegildo; Acosta, Raul; Godoy-Monzon, Daniel

    2014-01-01

    perspective of physician hosts in several hospitals in South America. Our results suggest that IHEs function best when EM residents rotate later in residency training and when relationships are maintained and deepened among those involved including host physicians, rotators, and institutions. This leads to future rotators, project collaboration, research, and publications which not only benefit individuals involved but also the wider field of Emergency Medicine.

  4. Fellowships in international emergency medicine in the USA: a comparative survey of program directors' and fellows' perspectives on the curriculum.

    PubMed

    Jacquet, Gabrielle A; Vu, Alexander; Ewen, William B; Hansoti, Bhakti; Andescavage, Steven; Price, David; Suter, Robert E; Bayram, Jamil D

    2014-01-01

    Experts have proposed core curriculum components for international emergency medicine (IEM) fellowships. This study examined perceptions of program directors (PDs) and fellows on whether IEM fellowships cover these components, whether their perspectives differ and the barriers preventing fellowships from covering them. From 1 November 2011 to 30 November 2011, a survey was administered to PDs, current fellows and recent graduates of the 34 US IEM fellowships. Respondents quantified their fellowship experience in six proposed core curriculum areas: emergency medicine (EM) systems development, EM education, humanitarian assistance, public health, emergency medical services and disaster medicine. Analysis was performed regarding what per cent of programmes fulfil the six curriculum areas. A paired t test determined the difference between PDs' and fellows' responses. Agreement between PDs and fellows within the same programme was determined using a κ statistic. Only 1/18 (6%) (according to fellows) to 2/24 (8%) (according to PDs) of programmes expose fellows to all six components. PDs consistently reported higher exposure than fellows. The difference in mean score between PDs and fellows was statistically significant (p<0.05) in three of the 6 (50%) core curriculum elements: humanitarian aid, public health and disaster medicine. Per cent agreement between PDs and fellows within each programmes ranged from poor to fair. While IEM fellowships have varying structure, this study highlights the importance of further discussion between PDs and fellows regarding delineation and objectives of core curriculum components. Transparent curricula and open communication between PDs and fellows may reduce differences in reported experiences.

  5. An overview of extended-spectrum beta-lactamases in veterinary medicine and their public health consequences.

    PubMed

    Nóbrega, Diego Borin; Brocchi, Marcelo

    2014-08-13

    Serious human and animal infections caused by bacteria are usually treated with beta-lactams. Extended-spectrum beta-lactamases (ESBLs) constitute the most clinically and economically important enzymes that are able to hydrolyze and inactivate beta-lactam antibiotics in veterinary medicine. The spread of ESBLs represents a serious threat to healthcare systems, drastically undermining therapeutic options. The relationship between drug usage and the emergence of resistance has been extensively reported. Nevertheless, the use of antimicrobials in veterinary medicine and the emergence of ESBLs in animals remains a matter of debate. Moreover, there is still controversy about whether antibiotic usage in farm animals poses a potential public health risk. This review will (i) deal with aspects related to the presence of ESBLs in veterinary medicine, (ii) its link with human medicine, and (iii) discuss strategies to be implemented to preserve antimicrobial effectiveness. New insights relative to old questions concerning antimicrobial use in domestic animals are also presented.

  6. Impact of an emergency medicine pharmacist on antibiotic dosing adjustment.

    PubMed

    DeWitt, Kyle M; Weiss, Steven J; Rankin, Shannon; Ernst, Amy; Sarangarm, Preeyaporn

    2016-06-01

    Overall medication-related errors in the emergency department (ED) are 13.5 times more likely to occur in the absence of an emergency medicine pharmacist (EMP). Although the effectiveness of pharmacist-driven renal dosing adjustment has been studied in the intensive care unit, data are lacking in the ED setting. The aim of our study was to evaluate the appropriateness of antibiotic dosing when an EMP is physically present in the ED compared to when absent. This was a retrospective cohort study of patients treated in a level I trauma center with 75 adult and 12 pediatric beds and an annual census of 90000 patients. The study period was from March 1 to September 30, 2014. An EMP was physically present in the ED from 11:00 to 01:30 and absent from 01:31 to 10:59. Male and female patients 18years and older were considered for inclusion if cefazolin, cefepime, ciprofloxacin, piperacillin-tazobactam, or vancomycin was ordered. The primary outcome was the composite rate of correct antibiotic dose and frequency. Statistics included a multivariable logistic regression using age, sex, presence of EMP, and creatinine clearance as independent predictors of correct antibiotic use. A total 210 cases were randomly chosen for evaluation, half during times when EMPs were present and half when they were absent. There were 130 males (62%) with an overall mean age of 54±18years. Overall, 178 (85%) of 210 of the antibiotic orders were appropriate, with 95% appropriate when an EMP was present compared to 74% when an EMP was absent (odds ratio, 6.9; 95% confidence interval, 2.5-18.8). In a logistic regression model, antibiotic appropriateness was independently associated with the presence of the EMP and creatinine clearance. Antibiotics that require renal and/or weight dosing adjustment are 6.5 times more likely to be appropriate in the ED when an EMP is present. Prevalence of antibiotic dosing error is related to both the presence of EMPs and the degree of renal impairment. Copyright

  7. Emergency department management of early sepsis: a national survey of emergency medicine and intensive care consultants.

    PubMed

    Jiwaji, Zoeb; Brady, Shirin; McIntyre, Lauralyn A; Gray, Alasdair; Walsh, Timothy S

    2014-12-01

    Early goal-directed therapy (EGDT) is recommended for sepsis management in current guidelines, but the underpinning evidence is controversial. Clinician beliefs and the capacity to implement all recommended elements of EGDT in emergency departments (EDs) are uncertain. Our study aimed to explore self-reported management of early sepsis by Scottish emergency medicine (EM) and intensive care medicine (ICM) consultants, delineate important differences and determine the guideline recommendations rated most important and deliverable within the ED. A postal survey using a hypothetical patient with septic shock was sent to all EM and ICM consultants practising in Scotland. 67% (76/114) EM and 61% (96/157) ICM consultants responded. Normal saline was preferred by EM respondents ('always/often used': EM 86%, ICM 23%, p<0.0001), whereas ICM respondents preferred Hartmann's solution (EM 42%, ICM 72%, p=0.0164), gelofusin (EM 10%, ICM 63%, p<0.0001) and starch (EM 0%, ICM 24%, p<0.0001). More ICM respondents indicated they used central venous pressure and invasive arterial pressure monitoring in the ED, and initiated vasopressors (EM 57%, ICM 90%, p<0.0001). More ICM consultants used specific haemoglobin transfusion triggers (48% EM, 77% ICM, p=0.0002), but marked variation in haemoglobin triggers and targets was reported. Lactate was rated the most important single resuscitation parameter by both specialties; no ED and only two ICM consultants rated ScVO2 most important. Differences in early fluid and vasopressor management of sepsis exist between Scottish ICM and EM consultants. Transfusion practice is highly variable, suggesting clinical uncertainty. Lactate is considered more important than ScVO2 measurement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Global health education in emergency medicine residency programs.

    PubMed

    Havryliuk, Tatiana; Bentley, Suzanne; Hahn, Sigrid

    2014-06-01

    Interest in global health and international electives is growing among Emergency Medicine (EM) residents in the United States (US). The majority of EM residency programs offer opportunities for international electives. The degree of participation among residents and type of support provided by the residency program, however, remains unclear. To explore the current state of global health education among EM residents who participate in international electives. A 12-question survey was e-mailed to the program directors of the 192 EM residency programs in the US. The survey included questions about the number of residents participating in international electives and the types of preparation, project requirements, supervision, and feedback participating residents receive. The response rate was 53% with 102 responses. Seventy-five of 102 (74%) programs reported that at least one resident participated in an international elective in the 2010-2011 academic year. Forty-three programs (42%) report no available funding to support any resident on an international elective. Residents receive no preparation for international work in 41 programs (40%). Only 25 programs (26%) required their residents to conduct a project while abroad. Forty-nine programs (48%) reported no formal debriefing session, and no formal feedback was collected from returning residents in 57 of 102 (59%) programs. The majority of EM residencies have residents participating in international electives. However, the programs report variable preparation, requirements, and resident supervision. These results suggest a need for an expanded and more structured approach to international electives undertaken by EM residents. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Simulation in Canadian postgraduate emergency medicine training - a national survey.

    PubMed

    Russell, Evan; Hall, Andrew Koch; Hagel, Carly; Petrosoniak, Andrew; Dagnone, Jeffrey Damon; Howes, Daniel

    2017-05-17

    Simulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada. A national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE. Resident and PR response rates were 63% (203/321) and 100% (16/16), respectively. Residents reported a median of 20 (range 0-150) hours of annual simulation training, with 52% of residents indicating that the time dedicated to simulation training met their needs. PRs reported the frequency of SBE sessions ranging from weekly to every 6 months, with 15 (94%) programs having an established simulation curriculum. Two (13%) of the programs used simulation for resident assessment, although 15 (94%) of PRs indicated that they would be comfortable with simulation-based assessment. The most common PR-identified barriers to administering simulation were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Interprofessional involvement in simulation was strongly valued by both residents and PRs. SBE is frequently used by Canadian FRCPC-EM residency programs. However, there exists considerable variability in the structure, frequency, and timing of simulation-based activities. As programs transition to competency-based medical education, national organizations and collaborations should consider the variability in how SBE is administered.

  10. Exploring Scholarship and the Emergency Medicine Educator: A Workforce Study

    PubMed Central

    Jordan, Jaime; Coates, Wendy C.; Clarke, Samuel; Runde, Daniel P.; Fowlkes, Emilie; Kurth, Jacqueline; Yarris, Lalena M.

    2017-01-01

    Introduction Recent literature calls for initiatives to improve the quality of education studies and support faculty in approaching educational problems in a scholarly manner. Understanding the emergency medicine (EM) educator workforce is a crucial precursor to developing policies to support educators and promote education scholarship in EM. This study aims to illuminate the current workforce model for the academic EM educator. Methods Program leadership at EM training programs completed an online survey consisting of multiple choice, completion, and free-response type items. We calculated and reported descriptive statistics. Results 112 programs participated. Mean number of core faculty/program: 16.02 ± 7.83 [14.53–17.5]. Mean number of faculty full-time equivalents (FTEs)/program dedicated to education is 6.92 ± 4.92 [5.87–7.98], including (mean FTE): Vice chair for education (0.25); director of medical education (0.13); education fellowship director (0.2); residency program director (0.83); associate residency director (0.94); assistant residency director (1.1); medical student clerkship director (0.8); assistant/associate clerkship director (0.28); simulation fellowship director (0.11); simulation director (0.42); director of faculty development (0.13). Mean number of FTEs/program for education administrative support is 2.34 ± 1.1 [2.13–2.61]. Determination of clinical hours varied; 38.75% of programs had personnel with education research expertise. Conclusion Education faculty represent about 43% of the core faculty workforce. Many programs do not have the full spectrum of education leadership roles and educational faculty divide their time among multiple important academic roles. Clinical requirements vary. Many departments lack personnel with expertise in education research. This information may inform interventions to promote education scholarship. PMID:28116031

  11. Exploring Scholarship and the Emergency Medicine Educator: A Workforce Study.

    PubMed

    Jordan, Jaime; Coates, Wendy C; Clarke, Samuel; Runde, Daniel P; Fowlkes, Emilie; Kurth, Jacqueline; Yarris, Lalena M

    2017-01-01

    Recent literature calls for initiatives to improve the quality of education studies and support faculty in approaching educational problems in a scholarly manner. Understanding the emergency medicine (EM) educator workforce is a crucial precursor to developing policies to support educators and promote education scholarship in EM. This study aims to illuminate the current workforce model for the academic EM educator. Program leadership at EM training programs completed an online survey consisting of multiple choice, completion, and free-response type items. We calculated and reported descriptive statistics. 112 programs participated. Mean number of core faculty/program: 16.02 ± 7.83 [14.53-17.5]. Mean number of faculty full-time equivalents (FTEs)/program dedicated to education is 6.92 ± 4.92 [5.87-7.98], including (mean FTE): Vice chair for education (0.25); director of medical education (0.13); education fellowship director (0.2); residency program director (0.83); associate residency director (0.94); assistant residency director (1.1); medical student clerkship director (0.8); assistant/associate clerkship director (0.28); simulation fellowship director (0.11); simulation director (0.42); director of faculty development (0.13). Mean number of FTEs/program for education administrative support is 2.34 ± 1.1 [2.13-2.61]. Determination of clinical hours varied; 38.75% of programs had personnel with education research expertise. Education faculty represent about 43% of the core faculty workforce. Many programs do not have the full spectrum of education leadership roles and educational faculty divide their time among multiple important academic roles. Clinical requirements vary. Many departments lack personnel with expertise in education research. This information may inform interventions to promote education scholarship.

  12. Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

    PubMed Central

    Robaina, Katherine

    2013-01-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry’s economic interests. PMID:23237151

  13. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

    PubMed

    Babor, Thomas F; Robaina, Katherine

    2013-02-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

  14. Do emergency medicine journals promote trial registration and adherence to reporting guidelines? A survey of "Instructions for Authors".

    PubMed

    Sims, Matthew T; Henning, Nolan M; Wayant, C Cole; Vassar, Matt

    2016-11-24

    The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross-tabulations and descriptive statistics were calculated using IBM SPSS 22. Of the 27 emergency medicine journals, 11 (11/27, 40.7%) did not mention a single guideline within their "Instructions for Authors," while the remaining 16 (16/27, 59.3%) mentioned one or more guidelines. The QUOROM statement and SRQR were not mentioned by any journals whereas the ICMJE guidelines (18/27, 66.7%) and CONSORT statement (15/27, 55.6%) were mentioned most often. Of the 27 emergency medicine journals, 15 (15/27, 55.6%) did not mention trial or review registration, while the remaining 12 (12/27, 44.4%) at least mentioned one of the two. Trial registration through ClinicalTrials.gov was mentioned by seven (7/27, 25.9%) journals while the WHO registry was mentioned by four (4/27, 14.8%). Twelve (12/27, 44.4%) journals mentioned trial registration through any registry platform. The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of

  15. ['Judicialization' of public health policy for distribution of medicines].

    PubMed

    Chieffi, Ana Luiza; Barata, Rita Barradas

    2009-08-01

    The supply of medicines in response to court orders or injunctions has become a common practice in the State of São Paulo, Brazil. This 'judicialization' of the health system clashes with basic principles of the Brazilian Unified National Health System (SUS), such as equal opportunity to access health services. The aim of this paper is to analyze the legal action used to obtain medicines through the São Paulo State Health Department, from two main angles: judicialization of public policies and breach of the equity principle. This is a descriptive study of legal action taken to obtain medicines through the São State Health Department, as listed in the Electronic Court Docket System for the year 2006. Most cases were filed through private attorneys; 47% of the patients had obtained their prescriptions through private care; and 73% of the cases involved patients from the three wealthiest areas in the city of São Paulo. The data demonstrate that such legal action violates key principles of the SUS such as equity, thereby privileging individuals with higher purchasing power and more access to information.

  16. How alternative payment models in emergency medicine can benefit physicians, payers, and patients.

    PubMed

    Harish, Nir J; Miller, Harold D; Pines, Jesse M; Zane, Richard D; Wiler, Jennifer L

    2017-06-01

    While there has been considerable effort devoted to developing alternative payment models (APMs) for primary care physicians and for episodes of care beginning with inpatient admissions, there has been relatively little attention by payers to developing APMs for specialty ambulatory care, and no efforts to develop APMs that explicitly focus on emergency care. In order to ensure that emergency care is appropriately integrated and valued in future payment models, emergency physicians (EPs) must engage with the stakeholders within the broader health care system. In this article, we describe a framework for the development of APMs for emergency medicine and present four examples of APMs that may be applicable in emergency medicine. A better understanding of how APMs can work in emergency medicine will help EPs develop new APMs that improve the cost and quality of care, and leverage the value that emergency care brings to the system. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The Emergence of Public Health Open Educational Resources

    ERIC Educational Resources Information Center

    Angell, C.; Hartwell, H.; Hemingway, A.

    2011-01-01

    Purpose: The purpose of this paper is to identify key concepts in the literature relating to the release of open educational resources (OER), with specific reference to the emergence of public health OER. Design/methodology/approach: A review of the literature relating to the development of OER was followed by an online search for OER literature…

  18. The Emergence of Public Health Open Educational Resources

    ERIC Educational Resources Information Center

    Angell, C.; Hartwell, H.; Hemingway, A.

    2011-01-01

    Purpose: The purpose of this paper is to identify key concepts in the literature relating to the release of open educational resources (OER), with specific reference to the emergence of public health OER. Design/methodology/approach: A review of the literature relating to the development of OER was followed by an online search for OER literature…

  19. Environmental factors influencing public health and medicine: policy implications.

    PubMed Central

    Warren, Rueben; Walker, Bailus; Nathan, Vincent R.

    2002-01-01

    Environmental health threats are increasing throughout the United States, particularly in low-income populations and in communities of color. Environmental science researchers are investigating plausible associations between the environment and human health. As a result, the role and responsibility of the primary care physicians and other health care providers are changing. This paper highlights selected lines of evidence suggesting that clinicians should now consider interactions between humans and their environment as central to providing effective primary care. Subject areas include: exposure to environmental agents, reproductive toxicity, pulmonary disease, neurobehavioral toxicity, endocrine disruptors, mechanisms of environmental disease, and cultural competence. Concerns about these and other environmentally related issues influence the manner in which primary care is practiced now, and will be practiced in the future. Biomedical technology and community awareness demand that physicians pay more attention to advances in environmental medicine. Ironically, one of the least taught subjects in medical school is environmental medicine. To effectively respond to growing concerns about the role of the environment in human health, clinicians, researchers, educators, public policy officials, and the general public must join together to reduce the risk of environmental health threats and improve quality of life. PMID:11995631

  20. A peer assessment approach for learning from public health emergencies.

    PubMed

    Piltch-Loeb, Rachael N; Nelson, Christopher D; Kraemer, John D; Savoia, Elena; Stoto, Michael A

    2014-01-01

    As an alternative to standard quality improvement approaches and to commonly used after action report/improvement plans, we developed and tested a peer assessment approach for learning from singular public health emergencies. In this approach, health departments engage peers to analyze critical incidents, with the goal of aiding organizational learning within and across public health emergency preparedness systems. We systematically reviewed the literature in this area, formed a practitioner advisory panel to help translate these methods into a protocol, applied it retrospectively to case studies, and later field-tested the protocol in two locations. These field tests and the views of the health professionals who participated in them suggest that this peer-assessment approach is feasible and leads to a more in-depth analysis than standard methods. Engaging people involved in operating emergency health systems capitalizes on their professional expertise and provides an opportunity to identify transferable best practices.

  1. A Peer Assessment Approach for Learning from Public Health Emergencies

    PubMed Central

    Piltch-Loeb, Rachael N.; Nelson, Christopher D.; Kraemer, John D.; Savoia, Elena

    2014-01-01

    As an alternative to standard quality improvement approaches and to commonly used after action report/improvement plans, we developed and tested a peer assessment approach for learning from singular public health emergencies. In this approach, health departments engage peers to analyze critical incidents, with the goal of aiding organizational learning within and across public health emergency preparedness systems. We systematically reviewed the literature in this area, formed a practitioner advisory panel to help translate these methods into a protocol, applied it retrospectively to case studies, and later field-tested the protocol in two locations. These field tests and the views of the health professionals who participated in them suggest that this peer-assessment approach is feasible and leads to a more in-depth analysis than standard methods. Engaging people involved in operating emergency health systems capitalizes on their professional expertise and provides an opportunity to identify transferable best practices. PMID:25355972

  2. Public health emergencies: nurses' recommendations for effective actions.

    PubMed

    O'Boyle, Carol; Robertson, Cheryl; Secor-Turner, Molly

    2006-08-01

    During a public health emergency such as an influenza pandemic or a bioterrorism attack, nurses may be at risk for exposure to lethal infectious diseases when caring for victims. The aim of this study was to identify interventions nurses believe will support their ability to cope during public health emergencies. A qualitative research design was used with 33 nurses from designated bioterrorism-receiving hospitals. Nurses recommended adequate protective equipment, education, drills, accessible information and available content experts, and available administrators. Other recommendations included increased security to protect nurses, emotional and physical support, communication with nurses' families, and commitment from institutions to care for ill or injured nurses. Preparations for emergencies should include assessments of nurses' and other stakeholders' concerns. These nurses proposed specific measures to improve safety, reduce anxiety, increase trust in hospitals, and provide physical and emotional support.

  3. Medicinal Plants: A Public Resource for Metabolomics and Hypothesis Development

    PubMed Central

    Wurtele, Eve Syrkin; Chappell, Joe; Daniel Jones, A.; Celiz, Mary Dawn; Ransom, Nick; Hur, Manhoi; Rizshsky, Ludmila; Crispin, Matthew; Dixon, Philip; Liu, Jia; Widrlechner, Mark P.; Nikolau, Basil J.

    2012-01-01

    database is publicly available and can be used by researchers in medicine and plant biology. PMID:24957774

  4. Patients' choice between public and private hospital emergency departments: a cross-sectional survey.

    PubMed

    He, Jun; Hou, Xiang-Yu; Toloo, Ghasem Sam; FitzGerald, Gerry

    2017-09-19

    The aim of this study was to understand what factors influence patients' choice between public and private hospital ED and the relative weight of those factors among adult patients with private health insurance in Australia. A survey of 280 patients was conducted in four public and private hospitals' EDs in Brisbane between May and August 2015. The survey included information about respondent's demographics, nature of illness, decision-making, attitudes and choice. Independent t-test and Pearson's χ²-test were used to identify binary associations, and logistic regression was used to determine what factors influence patients' choice. Patients who agreed that 'long waiting time is a barrier to access public hospital ED' were twice as likely to choose private hospitals (odds ratio [OR] 2.172, P = 0.001). Alternatively patients who did not consider that 'there were long waiting times in public hospital ED' were less likely to access private hospitals (OR 0.200, P = 0.003). More public hospital patients (70.7%) than private hospital patients (56.4%) (P = 0.015) agreed that 'out-of-pocket payment is a barrier to accessing private hospital ED'. Patients attending private hospitals rated the quality of service higher than those attending public hospitals (OR 1.26, P = 0.001). Longer waiting times in public EDs is the principal issue considered by patients choosing private EDs and the out-of-pocket payment for accessing private EDs is the principal issue considered by public ED patients. The study suggests that addressing the out-of-pocket payments will attract more patients with private health insurance to access private EDs. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  5. 75 FR 58411 - Center for Veterinary Medicine eSubmitter Workshop; Public Workshop; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... HUMAN SERVICES Food and Drug Administration Center for Veterinary Medicine eSubmitter Workshop; Public...: ``Center for Veterinary Medicine (CVM) eSubmitter Workshop.'' The purpose of the public workshop is to..., Center for Veterinary Medicine (HFV-100), Food and Drug Administration, 7520 Standish Pl., Rockville,...

  6. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    PubMed

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD.

  7. Social Networking for Emergency Management and Public Safety

    SciTech Connect

    Lesperance, Ann M.; Olson, Jarrod; Godinez, Melanie A.

    2010-08-31

    On March 10, 2010 the workshop titled Social Networking for Emergency Management and Public Safety was held in Seattle, WA. The objective of this workshop was to showcase ways social media networking technologies can be used to support emergency management and public safety operations. The workshop highlighted the current state of social networking and where this dynamic engagement is heading, demonstrated some of the more commonly used technologies, highlighted case studies on how these tools have been used in a variety of jurisdictions and engaged the private sector on how these tools might serve as a conduit for two way communication between with the public sector to address regional recovery issues and decision making.

  8. The efficacy and value of emergency medicine: a supportive literature review

    PubMed Central

    2011-01-01

    Study objectives The goal of this study was to identify publications in the medical literature that support the efficacy or value of Emergency Medicine (EM) as a medical specialty and of clinical care delivered by trained emergency physicians. In this study we use the term "value" to refer both to the "efficacy of clinical care" in terms of achieving desired patient outcomes, as well as "efficiency" in terms of effective and/or cost-effective utilization of healthcare resources in delivering emergency care. A comprehensive listing of publications describing the efficacy or value of EM has not been previously published. It is anticipated that the accumulated reference list generated by this study will serve to help promote awareness of the value of EM as a medical specialty, and acceptance and development of the specialty of EM in countries where EM is new or not yet fully established. Methods The January 1995 to October 2010 issues of selected journals, including the EM journals with the highest article impact factors, were reviewed to identify articles of studies or commentaries that evaluated efficacy, effectiveness, and/or value related to EM as a specialty or to clinical care delivered by EM practitioners. Articles were included if they found a positive or beneficial effect of EM or of EM physician-provided medical care. Additional articles that had been published prior to 1995 or in other non-EM journals already known to the authors were also included. Results A total of 282 articles were identified, and each was categorized into one of the following topics: efficacy of EM for critical care and procedures (31 articles), efficacy of EM for efficiency or cost of care (30 articles), efficacy of EM for public health or preventive medicine (34 articles), efficacy of EM for radiology (11 articles), efficacy of EM for trauma or airway management (27 articles), efficacy of EM for using ultrasound (56 articles), efficacy of EM faculty (34 articles), efficacy of EM

  9. Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

    PubMed

    Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

    2014-12-01

    Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

  10. Public health emergencies and the public health/managed care challenge.

    PubMed

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  11. Assessing radiation emergency preparedness planning by using community assessment for public health emergency response (CASPER) methodology.

    PubMed

    Nyaku, Mawuli K; Wolkin, Amy F; McFadden, Jevon; Collins, Jim; Murti, Michelle; Schnall, Amy; Bies, Shane; Stanbury, Martha; Beggs, Jennifer; Bayleyegn, Tesfaye M

    2014-06-01

    Approximately 1.2 million persons in Oakland County, Michigan (USA) reside less than 50 miles from the Fermi Nuclear Power Plant, Unit 2, but information is limited regarding how residents might react during a radiation emergency. Community Assessment for Public Health Emergency Response (CASPER) survey methodology has been used in disaster and non disaster settings to collect reliable and accurate population-based public health information, but it has not been used to assess household-level emergency preparedness for a radiation emergency. To improve emergency preparedness plans in Oakland County, including how residents might respond during a radiation emergency, Oakland County Health Division (OCHD), with assistance from the Centers for Disease Control and Prevention (CDC) and the Michigan Department of Community Health (MDCH), conducted a CASPER survey. During September 2012, a 2-stage cluster sampling design was used to select 210 representative households in Oakland County. By using in-person surveys, the proportion of households with essential needs and supplies, how residents might respond to public health authorities' instructions, and their main source for obtaining information during a radiation emergency were assessed. Data were weighted to account for the complex sampling design. Of the goal of 210 households, 192 (91.4%) surveys were completed: 64.7% and 85.4% of respondents indicated having 3-day supplies of water and of non perishable food, respectively; 62.8% had a 7-day supply of prescription medication for each person who needed it. Additionally, 64.2% had a working carbon monoxide detector; 67.1% had a first-aid kit; and 52% had an alternative heat source. In response to instructions from public health officials during a radiation emergency, 93.3% of all respondents would report to a radiation screening center; 96% would evacuate; and 91.8% would shelter-in-place. During a radiation emergency, 55.8% of respondents indicated their main

  12. An Analysis of the Top-cited Articles in Emergency Medicine Education Literature.

    PubMed

    Munzer, Brendan W; Love, Jeffery; Shipman, Barbara L; Byrne, Brendan; Cico, Stephen J; Furlong, Robert; Khandelwal, Sorabh; Santen, Sally A

    2017-01-01

    Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms. We searched 19 EM journals for education articles as well as all other literature for EM education-related articles. Articles identified were reviewed for citation count, article type, journal, authors, and publication year. With regards to EM journals, the greatest number of articles were classified as articles/reviews, followed by research articles on topics such as deliberate practice (cited 266 times) and cognitive errors (cited 201 times). In contrast in the non-EM journals, research articles were predominant. Both searches found several simulation and ultrasound articles to be included. The most common EM journal was Academic Emergency Medicine (n = 18), and Academic Medicine was the most common non-EM journal (n=5). A reasonable number of articles included external funding sources (6 EM articles and 13 non-EM articles.). This study identified the most frequently cited medical education articles in the field of EM education, published in EM journals as well as all other journals indexed in Web of Science. The results identify impactful articles to medical education, providing a resource to educators while identifying trends that may be used to guide EM educational research and publishing efforts.

  13. An Analysis of the Top-cited Articles in Emergency Medicine Education Literature

    PubMed Central

    Munzer, Brendan W.; Love, Jeffery; Shipman, Barbara L.; Byrne, Brendan; Cico, Stephen J.; Furlong, Robert; Khandelwal, Sorabh; Santen, Sally A.

    2017-01-01

    Introduction Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. Methods Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms. We searched 19 EM journals for education articles as well as all other literature for EM education-related articles. Articles identified were reviewed for citation count, article type, journal, authors, and publication year. Results With regards to EM journals, the greatest number of articles were classified as articles/reviews, followed by research articles on topics such as deliberate practice (cited 266 times) and cognitive errors (cited 201 times). In contrast in the non-EM journals, research articles were predominant. Both searches found several simulation and ultrasound articles to be included. The most common EM journal was Academic Emergency Medicine (n = 18), and Academic Medicine was the most common non-EM journal (n=5). A reasonable number of articles included external funding sources (6 EM articles and 13 non-EM articles.) Conclusion This study identified the most frequently cited medical education articles in the field of EM education, published in EM journals as well as all other journals indexed in Web of Science. The results identify impactful articles to medical education, providing a resource to educators while identifying trends that may be used to guide EM educational research and publishing efforts. PMID:28116010

  14. Emergency medicine resident research requirements and director characteristics.

    PubMed

    Blanda, M; Gerson, L W; Dunn, K

    1999-04-01

    To describe emergency medicine (EM) residency program research requirements, characterize research directors (RDs), and describe their research activities and productivity. A survey with questions addressing program research requirements, RDs' background, type of research productivity, time spent, and compensation was mailed to RDs at all Accreditation Council for Graduate Medical Education (ACGME)-approved programs. One hundred of 111 (90%) RDs responded; 54 of the 100 respondents were from university programs. Research is a formal requirement in 80% of EM programs. Writing a manuscript (35%) and major involvement in a project (31%) are the most common minimum requirements. University and community programs had similar research requirements and were equally likely to have delayed/withheld certificates. Eighty-six percent of the RDs were male; 70% held this position for <5 years and 70% plan on being in the position for <5 additional years. More than half were junior faculty and 21 had completed a fellowship. Most (88%) did not serve in an associate RD position, and currently only 20 programs reported having this position. Fifty-four percent had protected time. Median hour/week time allocations are: clinical-22, own research--10, other people's research--6, administration--5, and department administration--5. Factors associated with research productivity were senior rank (OR 6.87), having a research assistant (OR 4.78), protected time for their own research (OR 3.06), and reporting that extramural funding was considered in the RD's performance evaluation (OR 2.69). Most programs have established research requirements. Most RDs are junior faculty, have limited research training, expect a short tenure in the position, and have variable access to research resources. EM needs to foster an environment that will enable us to thrive in the academic community and create opportunity for residents to participate in meaningful research. This requires that all RDs have

  15. Supplemental Milestones for Emergency Medicine Residency Programs: A Validation Study

    PubMed Central

    Ketterer, Andrew R.; Salzman, David H.; Branzetti, Jeremy B.; Gisondi, Michael A.

    2017-01-01

    Introduction Emergency medicine (EM) residency programs may be 36 or 48 months in length. The Residency Review Committee for EM requires that 48-month programs provide educational justification for the additional 12 months. We developed additional milestones that EM training programs might use to assess outcomes in domains that meet this accreditation requirement. This study aims to assess for content validity of these supplemental milestones using a similar methodology to that of the original EM Milestones validation study. Methods A panel of EM program directors (PD) and content experts at two institutions identified domains of additional training not covered by the existing EM Milestones. This led to the development of six novel subcompetencies: “Operations and Administration,” “Critical Care,” “Leadership and Management,” “Research,” “Teaching and Learning,” and “Career Development.” Subject-matter experts at other 48-month EM residency programs refined the milestones for these subcompetencies. PDs of all 48-month EM programs were then asked to order the proposed milestones using the Dreyfus model of skill acquisition for each subcompetency. Data analysis mirrored that used in the original EM Milestones validation study, leading to the final version of our supplemental milestones. Results Twenty of 33 subjects (58.8%) completed the study. No subcompetency or individual milestone met deletion criteria. Of the 97 proposed milestones, 67 (69.1%) required no further editing and remained at the same level as proposed by the study authors. Thirty milestones underwent level changes: 15 (15.5%) were moved one level up and 13 (13.4%) were moved one level down. One milestone (1.0%) in “Leadership and Management” was moved two levels up, and one milestone in “Operations and Administration” was moved two levels down. One milestone in “Research” was ranked by the survey respondents at one level higher than that proposed by the authors

  16. Nonemergency Medicine-Trained Physician Coverage in Rural Emergency Departments

    ERIC Educational Resources Information Center

    Peterson, Lars E.; Dodoo, Martey; Bennett, Kevin J.; Bazemore, Andrew; Phillips, Robert L., Jr.

    2008-01-01

    Context: Rural areas have fewer physicians compared to urban areas, and rural emergency departments often rely on community or contracted providers for staffing. The emergency department workforce is composed of a variety of physician specialties and clinicians. Purpose: To determine the distribution of emergency department clinicians and the…

  17. Nonemergency Medicine-Trained Physician Coverage in Rural Emergency Departments

    ERIC Educational Resources Information Center

    Peterson, Lars E.; Dodoo, Martey; Bennett, Kevin J.; Bazemore, Andrew; Phillips, Robert L., Jr.

    2008-01-01

    Context: Rural areas have fewer physicians compared to urban areas, and rural emergency departments often rely on community or contracted providers for staffing. The emergency department workforce is composed of a variety of physician specialties and clinicians. Purpose: To determine the distribution of emergency department clinicians and the…

  18. Impact of learners on emergency medicine attending physician productivity.

    PubMed

    Bhat, Rahul; Dubin, Jeffrey; Maloy, Kevin

    2014-02-01

    Several prior studies have examined the impact of learners (medical students or residents) on overall emergency department (ED) flow as well as the impact of resident training level on the number of patients seen by residents per hour. No study to date has specifically examined the impact of learners on emergency medicine (EM) attending physician productivity, with regards to patients per hour (PPH). We sought to evaluate whether learners increase, decrease, or have no effect on the productivity of EM attending physicians in a teaching program with one student or resident per attending. This was a retrospective database review of an urban, academic tertiary care center with 3 separate teams on the acute care side of the ED. Each team was staffed with one attending physician paired with either one resident, one medical student or with no learners. All shifts from July 1, 2008 to June 30, 2010 were reviewed using an electronic database. We predefined a shift as "Resident" if > 5 patients were seen by a resident, "Medical Student" if any patients were seen by a medical student, and "No Learners" if no patients were seen by a medical student or resident. Shifts were removed from analysis if more than one learner saw patients during the shift. We further stratified resident shifts by EM training level or off-service rotator. For each type of shift, the total number of patients seen by the attending physician was then divided by 8 hours (shift duration) to arrive at number of patients per hour. We analyzed a total of 7,360 shifts with 2,778 removed due to multiple learners on a team. For the 2,199 shifts with attending physicians with no learners, the average number of PPH was 1.87(95% confidence interval [CI] 1.86,1.89). For the 514 medical student shifts, the average PPH was 1.87(95% CI 1.84,1.90), p = 0.99 compared with attending with no learner. For the 1,935 resident shifts, the average PPH was 1.99(95% CI 1.97,2.00). Compared with attending physician with no

  19. The emergence and potential impact of medicine 2.0 in the healthcare industry.

    PubMed

    Stump, Terra; Zilch, Sarah; Coustasse, Alberto

    2012-01-01

    Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors' purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.

  20. Public Health Ethics Related Training for Public Health Workforce: An Emerging Need in the United States

    PubMed Central

    Kanekar, A; Bitto, A

    2012-01-01

    Background Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results: Results indicated a variable amount of ethics’ related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties’ needing separate ethical frameworks to guide decision making. Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice. PMID:23113159

  1. Public health ethics related training for public health workforce: an emerging need in the United States.

    PubMed

    Kanekar, A; Bitto, A

    2012-01-01

    Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making. Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

  2. Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

    PubMed

    Hadi, Tamer A; Fleshler, Keren

    2016-10-01

    Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

  3. Productivity and career paths of previous recipients of Society for Academic Emergency Medicine research grant awards.

    PubMed

    Young, Kelly D

    2008-06-01

    The objective was to assess productivity of previous recipients of Society for Academic Emergency Medicine (SAEM) grant awards. All previous recipients of SAEM Research Training Grants, Neuroscience Research Awards, Scholarly Sabbatical Awards, and Emergency Medical Services (EMS) Research Fellowship awards funded through 2004 were identified through SAEM's records and surveyed. Award categories assessed were those still offered by SAEM at the time of the survey and therefore excluded the Geriatric Research Award. The 2005-2006 SAEM Grants Committee developed a survey using previous publications assessing productivity of training grants and fellowship awards and refined it through consensus review and limited pilot testing. We assessed measures of academic productivity (numbers of publications and additional grants awarded), commitment to an academic career, satisfaction with the SAEM award, and basic demographic information. Overall response rate was 70%; usable data were returned by all seven Research Training Grant awardees, both Neuroscience awardees, four of five Scholarly Sabbatical awardees, and six of 14 EMS Research Fellowship awardees. Of those who gave demographic information, 78% (14/18) were male and 94% (16/17) were non-Hispanic white. All the respondents remained in academics, and 14 of 19 felt that they will definitely be in academics 5 years from the time of the survey. They have a median of 1.8 original research publications per year since the end of their grant period, and 74% (14/19) have received subsequent federal funding. All found the SAEM award to be helpful or very helpful to their careers. Previous recipients of the SAEM grant awards show evidence of academic productivity in the form of subsequent grant funding and research publications, and the majority remain committed to and satisfied with their academic research careers.

  4. Emergency medicine in pediatric dentistry: preparation and management.

    PubMed

    Malamed, Stanley F

    2003-10-01

    Medical emergencies can and do occur in the practice of dentistry. Although most emergencies take place in adults, serious problems can also develop in younger patients. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that do arise. Basic life support (as necessary) is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others. Preparation of the office and staff includes basic life support (annually), pediatric advanced life support, development of an emergency team, consideration for emergency medical services, and the availability of emergency drugs and equipment with the ability to use these items effectively. As with the adult patient, effective management of pain (local anesthesia) and anxiety (behavioral management, conscious sedation) will minimize the development of medical emergencies.

  5. Considerations for Use of Investigational Drugs in Public Health Emergencies

    PubMed Central

    Kirchoff, Matthew Carl; Pierson, Jerome F.

    2017-01-01

    The paradigm for the use of investigational drugs in public health emergencies has been recently tested to prevent and treat highly infectious and lethal diseases. Examples include the successful implementation of vaccine and therapeutic clinical trials during the recent Ebola outbreak in West Africa. On the other end of the spectrum was the Emergency Use Authorization (EUA) of peramivir in the treatment of H1N1 influenza virus that did not provide an opportunity to collect data or understand the effectiveness of the EUA program. Between the gold standard of a randomized controlled clinical trial and the problems associated with EUAs are the domain of expanded access protocols that may provide an avenue to make products available while awaiting licensure. This paper will examine the regulatory pathways in the United States (US) for the use of investigational drugs in a public health emergency as well as considerations when making these products available outside the US. Descriptions of the applications of the various approaches will be presented. Regardless of the pathway chosen, public health and clinical research planners need to work together to consider several factors associated with the respective options and maintain a goal of working toward the collection of data to support licensure before faced with future outbreaks. Finally, this paper will consider the lessons learned from public health response in the context of investigational drugs in other diseases where “right to try laws” may pose opportunities, as well as challenges. PMID:28663940

  6. Considerations for Use of Investigational Drugs in Public Health Emergencies.

    PubMed

    Kirchoff, Matthew Carl; Pierson, Jerome F

    2017-03-01

    The paradigm for the use of investigational drugs in public health emergencies has been recently tested to prevent and treat highly infectious and lethal diseases. Examples include the successful implementation of vaccine and therapeutic clinical trials during the recent Ebola outbreak in West Africa. On the other end of the spectrum was the Emergency Use Authorization (EUA) of peramivir in the treatment of H1N1 influenza virus that did not provide an opportunity to collect data or understand the effectiveness of the EUA program. Between the gold standard of a randomized controlled clinical trial and the problems associated with EUAs are the domain of expanded access protocols that may provide an avenue to make products available while awaiting licensure. This paper will examine the regulatory pathways in the United States (US) for the use of investigational drugs in a public health emergency as well as considerations when making these products available outside the US. Descriptions of the applications of the various approaches will be presented. Regardless of the pathway chosen, public health and clinical research planners need to work together to consider several factors associated with the respective options and maintain a goal of working toward the collection of data to support licensure before faced with future outbreaks. Finally, this paper will consider the lessons learned from public health response in the context of investigational drugs in other diseases where "right to try laws" may pose opportunities, as well as challenges.

  7. Sabbatical programs and the status of academic emergency medicine: a survey.

    PubMed

    Bernstein, E; James, T; Bernstein, J

    1999-09-01

    The Society for Academic Emergency Medicine (SAEM) commissioned a survey in 1998 to describe sabbatical programs, academic rank, and tenure, and to shed light on factors affecting the continuum of faculty development, as a context for evaluating the potential importance of emergency medicine (EM) sabbatical programs. The chairs of 120 EM residency programs were surveyed. The response rate was 90%. Of 108 responses, 44 were academic EM departments (AEMDs); ten were their affiliates. The setting was urban for 82%; 37% were publicly funded and 58% privately. AEMDs were more likely to have a tenure track and eligibility for a sabbatical program, but not more likely to use a sabbatical program. Among 2,042 ranked EM faculty, there were 121 professors and 346 associate professors. Mean sabbatical length was six months, provided at full pay requiring a mean of 5.7 years of employment. Among 39 programs reporting eligibility for an EM sabbatical, requirements included: tenure (43%), academic rank of associate professor (78%), an application with multiple approval levels (92%), and a formal report (75%). Thirteen EM programs used sabbaticals; only 40 faculty members altogether (9% of senior faculty) have taken sabbaticals. The mean value of sabbaticals (rated by users on a scale of 1 to 10) was 6.8. Reduced funding, lack of departmental status, difficulty retaining faculty, Health Care Financing Administration (HCFA) regulations, graduate medical education (GME) cutbacks, and no release time were identified as challenges for emergency physicians (EPs) wishing to participate in sabbaticals. Strategies proposed to overcome these obstacles include quality customer service, streamlined operations, outside contracts, computerization, hiring individuals with PhDs, collaboration, political activity, and faculty development. A sabbatical can be beneficial for individuals and their institutions, but presently EPs have not been able to maximize use of available opportunities. Some

  8. Radiological emergency preparedness: a survey of nuclear medicine technologists in the United States.

    PubMed

    Van Dyke, Miriam E; McCormick, Lisa C; Bolus, Norman E; Pevear, Jesse; Kazzi, Ziad N

    2013-09-01

    Because of the increasing risk of radiological emergencies, public health agencies and first-response organizations are working to increase their capability of responding. Nuclear medicine technologists (NMTs) have expertise in certain areas, such as radiation safety, radiobiology, decontamination, and the use of radiation detection and monitoring equipment, that could be useful during the response to events that involve radiological materials. To better understand the potential role that NMTs may have in response efforts, a cross-sectional survey was conducted. The survey was sent electronically to the 7,000 members of the Technology Section of the Society of Nuclear Medicine and Molecular Imaging. Eight hundred fifty NMTs responded to the survey, for a response rate of 12.14%. The study queried NMTs across the United States on their knowledge of using radiation detection and monitoring equipment, such as a scintillation γ-cameras, Geiger counters, thyroid probes, well counters, and portal monitors; willingness to participate in response efforts during a nuclear reactor accident, nuclear weapon detonation, or dirty bomb detonation; access to radiation detection and monitoring equipment within their work setting; familiarity with current preparedness guidance and tools provided by the Centers for Disease Control and Prevention and U.S. Department of Health and Human Services; and registration in volunteer initiatives such as the Emergency System for Advance Registration of Volunteer Health Professionals, Metropolitan Medical Response System, and Medical Reserve Corps. Survey results suggest that NMTs are knowledgeable and willing to respond to radiological emergencies, regardless of number of years of work experience. Radiological preparedness training within the last 5 y significantly increases NMTs' willingness to respond and familiarity with current guidance and tools provided by the Centers for Disease Control and Prevention and Department of Health and Human

  9. Public/private sector partnership for emerging infections.

    PubMed Central

    Bond, E. C.

    2001-01-01

    This paper gives examples of public/private partnerships that support research, support drug development and that advance policy development, suggesting that such partnerships can advance our understanding and control of emerging infections. The investment in emerging infectious diseases from government and from industry is currently much larger than that from philanthropy. Nevertheless philanthropy, even with limited dollars, is able to play a catalytic function and provide risk capitol for innovative partnerships and could in the future play an even larger role if the value of such investment is better defined and argued to recruit additional dollars to this area. PMID:11485645

  10. Baltimore's Unrest: Perspectives From Public Health and Emergency Physician Leaders.

    PubMed

    Khaldun, Joneigh S; Warren, Katherine E; Wen, Leana S

    2016-04-01

    The tragic April 19, 2015, death of an African American man injured while in police custody spurred several days of protest and civil unrest in Baltimore City. This article outlines the opportunity and role for a local health department during civil unrest, from the perspective of 2 emergency physicians who also led the Baltimore City Health Department through these recent events. Between April 27 and May 8, 2015, the Health Department was a lead agency in the unrest response and recovery activities. Similar to an emergency medical situation, a "public health code" is proposed as a model for centralizing, reacting to, and debriefing after situations of civil unrest.

  11. Regionalization and emergency care: the institute of medicine reports and a federal government update.

    PubMed

    Carr, Brendan G; Asplin, Brent R

    2010-12-01

    The 2010 Academic Emergency Medicine consensus conference on regionalization in emergency care began with an update on the Institute of Medicine (IOM) reports on the Future of Emergency Care. This was followed by two presentations from federal officials, focusing on regionalization from the perspective of the White House National Security Staff and the Emergency Care Coordination Center. This article summarizes the content of these presentations. It should be noted that this summary is the perspective of the authors and does not represent the official policy of the U.S. government.

  12. Development of a training needs assessment for an education scholarship fellowship in emergency medicine.

    PubMed

    Lin, Michelle; Santen, Sally A; Yarris, Lalena M; Mullan, Patricia; Searle, Nancy; Rougas, Steven; Coates, Wendy C

    2012-12-01

    At the 2012 Academic Emergency Medicine consensus conference, "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success," a breakout session convened to discuss postgraduate fellowship training in emergency medicine (EM), which would focus on education research. Graduates will form a growing cadre of education scholars who conduct and publish quality education research. This proceedings article reports the consensus findings of a breakout session subgroup whose goal was to construct a needs assessment for the proposed 2-year education scholarship fellowship. The authors describe, based on expert and participant consensus, a framework for a large-scale, mixed-methods needs assessment for such a fellowship. © 2012 by the Society for Academic Emergency Medicine.

  13. A Consensus-Driven Agenda for Emergency Medicine Firearm Injury Prevention Research.

    PubMed

    Ranney, Megan L; Fletcher, Jonathan; Alter, Harrison; Barsotti, Christopher; Bebarta, Vikhyat S; Betz, Marian E; Carter, Patrick M; Cerdá, Magdalena; Cunningham, Rebecca M; Crane, Peter; Fahimi, Jahan; Miller, Matthew J; Rowhani-Rahbar, Ali; Vogel, Jody A; Wintemute, Garen J; Waseem, Muhammad; Shah, Manish N

    2017-02-01

    To identify critical emergency medicine-focused firearm injury research questions and develop an evidence-based research agenda. National content experts were recruited to a technical advisory group for the American College of Emergency Physicians Research Committee. Nominal group technique was used to identify research questions by consensus. The technical advisory group decided to focus on 5 widely accepted categorizations of firearm injury. Subgroups conducted literature reviews on each topic and developed preliminary lists of emergency medicine-relevant research questions. In-person meetings and conference calls were held to iteratively refine the extensive list of research questions, following nominal group technique guidelines. Feedback from external stakeholders was reviewed and integrated. Fifty-nine final emergency medicine-relevant research questions were identified, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some questions could be addressed through research conducted in emergency departments; others would require work in other settings. The technical advisory group identified key emergency medicine-relevant firearm injury research questions. Emergency medicine-specific data are limited for most of these questions. Funders and researchers should consider increasing their attention to firearm injury prevention and control, particularly to the questions identified here and in other recently developed research agendas. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  14. Effect of emergency medicine pharmacists on medication-error reporting in an emergency department.

    PubMed

    Weant, Kyle A; Humphries, Roger L; Hite, Kimberly; Armitstead, John A

    2010-11-01

    The effect of an emergency medicine (EM) clinical pharmacist on medication-error reporting in an emergency department (ED) was studied. The medication-error reports for patients seen at a university's ED between September 1, 2005, and February 28, 2009, were retrospectively reviewed. Errors reported before the addition of an EM pharmacist (from September 1, 2005, through February 28, 2006) were compared with those reported after the addition of two EM pharmacists (from September 1, 2008, through February 28, 2009). The severity of errors and the provider who reported the errors were characterized. A total of 402 medication errors were reported over the two time periods. Pharmacy personnel captured significantly more errors than did other health care personnel (94.5% versus 5.7%, p < 0.001). The addition of two EM pharmacists resulted in 14.8 times as many medication-error reports as were made when no EM pharmacist was in the ED. More errors that actually occurred were captured with two pharmacists providing care (95.7% versus 4.3%, p < 0.001). A majority of the errors documented were ordering errors (79.8%). Of these, 73.7% were captured after the addition of two EM pharmacists. Performance (40.0%) and knowledge (27.9%) deficits were the most common contributing factors to medication errors. During the study period after the addition of two EM pharmacists in the ED, 371 medication-error reports were completed, compared with 31 reports during the study period before the addition of the pharmacists. Pharmacy personnel reported the majority of medication errors during both study periods.

  15. Effect of a brief emergency medicine education course on emergency department work intensity of family physicians.

    PubMed

    Vaillancourt, Samuel; Schultz, Susan E; Leaver, Chad; Stukel, Thérèse A; Schull, Michael J

    2013-01-01

    Recently, many Canadian emergency departments (EDs) have struggled with physician staffing shortages. In 2006, the Ontario Ministry of Health and Long-Term Care funded a brief "emergency medicine primer" (EMP) course for family physicians to upgrade or refresh skills, with the goal of increasing their ED work intensity. We sought to determine the effect of the EMP on the ED work intensity of family physicians. A retrospective longitudinal study was conducted of the ED work of 239 family physicians in the 2 years before and after a minimum of 6 months and up to 2 years from completing an EMP course in 2006 to 2008 compared to non-EMP physicians. ED work intensity was defined as the number of ED shifts per month and the number of ED patients seen per month. We conducted two analyses: a before and after comparison of all EMP physicians and a matched cohort analysis matching each EMP physician to four non-EMP physicians on sex, year of medical school graduation, rurality, and pre-EMP ED work intensity. Postcourse, EMP physicians worked 0.5 more ED shifts per month (13% increase, p  =  0.027). Compared to their matched controls, EMP physicians worked 0.7 more shifts per month (13% increase, p  =  0.0032) and saw 15 more patients per month (17% increase, p  =  0.0008) compared to matched non-EMP physicians. The greatest increases were among EMP physicians who were younger, were urban, had previous ED experience, or worked in a high-volume ED. The effect of the EMP course was negligible for physicians with no previous ED experience or working in rural areas. The EMP course is associated with modest increases in ED work intensity among some family physicians, in particular younger physicians in urban areas. No increase was seen among physicians without previous ED experience or working in rural areas.

  16. Development of emergency medicine as academic and distinct clinical discipline in Bosnia & Herzegovina.

    PubMed

    Salihefendic, Nizama; Zildzic, Muharem; Masic, Izet; Hadziahmetovic, Zoran; Vasic, Dusko

    2011-01-01

    Emergency medicine is a new academic discipline, as well as a recent independent clinical specialization with the specific principles of practice, education and research. It is also a very important segment of the overall health care and health system. Emergency medicine as a distinct specialty was introduced in the U.S. in 1970. Ten years later and relatively quickly emergency medicine was introduced in the health system in Bosnia and Herzegovina as a specialty with a special education program for specialist and a final exam. Compare the development of emergency medicine in Bosnia and Herzegovina with the trends of development of this discipline in the world as a specialization and an academic discipline. Identify specific problems and possible solutions and learn lessons from other countries. Reviewed are the literature data on the development of emergency medicine in the world, programs of undergraduate and postgraduate teaching, the organizational scheme of emergency centers and residency. This is then compared with data of the current status of emergency medicine as an academic discipline and a recognized specialization, in Bosnia and Herzegovina. There are substantial differences in the development of emergency medicine in the United States, European Union and Bosnia and Herzegovina. Although Bosnia and Herzegovina relatively early recognized specialty of emergency medicine in academia, it failed to mach the academic progress with the practical implementation. A&E departments in the Community Health Centers failed to meet the desired objectives even though they were led by specialists in emergency medicine. The main reason being the lack of space and equipment as well as staff needed to meet set standards of good clinical practice, education and research. Furthermore the Curriculum of undergraduate education and specialization does not match modern concept of educational programs that meet the principles set out in emergency medicine and learning through

  17. [Consciousness and abilities on health emergency and the roles of emergency response among public at the communities].

    PubMed

    Li, Yang; Dong, Xao-mei; Wang, Sheng-yong; Tian, Jun-zhang; Ye, Ze-bing; Yang, Jian; Li, Guan-ming; Peng, Lin; Zhang, Si-heng

    2013-10-01

    To evaluate the consciousness of health emergency and the abilities on self- and mutual medical aids among the public at the community level, as well as the community responses on health-related emergencies and other factors. Random equidistant sampling method was used to extract 617 households before choosing a family member sampled by Kish Grid method. All the members were investigated face to face on a questionnaire-"Health emergency and related ability regarding self and mutual medical aids of the residents". Data were entered into computer database by using software Epi Data 3.1 and were analyzed by SPSS 21.0. Among the 617 households under survey, 47.84% of the public had general awareness on health-related emergencies. Regarding the following items as:prevention and isolation strategies of infectious disease, on safely procedures of earthquake and fires, on prevention of food poisoning, on prevention and first aid of emerging infectious diseases etc., the rates of awareness were 65.04%, 62.92%, 43.62% and 18.79% respectively. Proportions of households which had the first aid supplies were:first aid medicine box as 56.08%; fire extinguisher as 43.60%; spare water and food as 39.40%; having facilities as ropes, whistles and smoke masks for escape were all less than 15%. Rates of awareness on the following items as: correct use of gas switch as 81.52%, knowing the location of the circuit with gear and the fire hydrant as 74.39% and 35.98% , respectively. The correct disposal rates of the residents on the following items were:electric shock and falls (89.63%), patients of infectious diseases (83.31%), gas poisoning (82.98%), suspected symptoms on infectious diseases(82.66%), explosion and burns (66.78%), scald (62.72%)and sprain (57.05%). Scores on the related abilities were as follows: emergency(7.65, out of 10 points), escape(3.55, out of 5 points), self- and mutual medical aids (10.71, out of 16 points). Proportions of having learned and applied of first aid

  18. The writer's guide to education scholarship in emergency medicine: Education innovations (part 3).

    PubMed

    Hall, Andrew K; Hagel, Carly; Chan, Teresa M; Thoma, Brent; Murnaghan, Aleisha; Bhanji, Farhan

    2017-06-20

    The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.

  19. Essentials of Pediatric Emergency Medicine Fellowship: Part 4: Beyond Clinical Education.

    PubMed

    Wolff, Margaret; Carney, Michele; Eldridge, Charles; Zaveri, Pavan; Kou, Maybelle

    2016-08-01

    This article is the third in a 7-part series that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated upon program completion. This article focuses on the skills beyond clinical training required of pediatric emergency medicine physicians including teaching, leadership, teamwork, and communication.

  20. Pediatric Motor Vehicle-Pedestrian Accident: a Simulation Scenario for Emergency Medicine Trainees

    PubMed Central

    Mathieson, Sarah; Dubrowski, Adam

    2017-01-01

    Simulation-based medical education is an evolving field that allows trainees to practice skills in a safe environment with no risk to patients. Recently, technology-enhanced simulation for emergency medicine learners has been shown to have favorable effects on learner knowledge and patient outcomes. In this report, a human patient simulator is used to familiarize emergency medicine trainees with the presentation and management of a pediatric motor vehicle-pedestrian accident is described. PMID:28367390

  1. A new emergency medicine clerkship program: students' perceptions of what works.

    PubMed

    Yeung, Marianne; Beecker, Jennifer; Marks, Meridith; Nuth, Janet; Weitzman, Brian; Lee, A Curtis; Frank, Jason R

    2010-05-01

    Emergency medicine is an evolving discipline in Canadian medical schools. Little has been published regarding student preferences for emergency medicine training during the clerkship phase of MD programs. We assessed medical students' perceptions of a newly developed emergency medicine clerkship rotation involving multiple learning modalities. The evaluation process included assessment of the rotation's instructional elements and overall educational value. The first cohort of medical students to complete this new emergency medicine clerkship was invited to answer a questionnaire just before graduation. Students rated their preferences for components of the rotation using paired comparisons. Open ended questions explored students' satisfaction with the emergency medicine clerkship as well as perceptions of the rotation's impact on career development. Of the 94 students in the first clerkship cohort, 81 (86%) responded to the survey. Students found the emergency medicine clerkship highly valuable, citing the broad range of cases seen, close supervision, and opportunities to develop clinical assessment, decision making and procedural skills. Students' curricular preferences were for advanced cardiac life support (ACLS) (26.4%), clinical shifts (20.6%), supervised clinical shifts (17.8%), procedural skills laboratories (14.8%), tutorials (10.8%) and preceptor assisted learning sessions (9.8%). This new emergency medicine clerkship program incorporated multiple learning methods within a 4-week rotation and was highly rated by students. Although clinical shifts and ACLS were generally preferred activities, students had varying individual preferences for specific learning activities. Multiple learning methods allowed all students to benefit from the rotation. This study makes a compelling case for including an emergency medicine rotation with multiple learning modalities as a core element of clerkship at every medical school.

  2. Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.

    PubMed

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-05-01

    The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden curriculum" in medical education, in which values are communicated from teacher to student outside of the formal instruction. A group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study. For Psychiatry clerks, t-tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine. Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

  3. Demand for public hospital emergency department services in Australia: 2000-2001 to 2009-2010.

    PubMed

    FitzGerald, Gerry; Toloo, Sam; Rego, Joanna; Ting, Joseph; Aitken, Peter; Tippett, Vivienne

    2012-02-01

    Hospital EDs are a significant and high-profile component of Australia's health-care system, which in recent years have experienced considerable crowding. This crowding is caused by the combination of increasing demand, throughput and output factors. The aim of the present article is to clarify trends in the use of public ED services across Australia with a view to providing an evidence basis for future policy analysis and discussion. The data for the present article have been extracted, compiled and analysed from publicly available sources for a 10 year period between 2000-2001 and 2009-2010. Demand for public ED care increased by 37% over the decade, an average annual increase of 1.8% in the utilization rate per 1000 persons. There were significant differences in utilization rates and in trends in growth among states and territories that do not easily relate to general population trends alone. This growth in demand exceeds general population growth, and the variability between states both in utilization rates and overall trends defies immediate explanation. The growth in demand for ED services is a partial contributor to the crowding being experienced in EDs across Australia. There is a need for more detailed study, including qualitative analysis of patient motivations in order to identify the factors driving this growth in demand. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. The National Network of Libraries of Medicine's outreach to the public health workforce: 2001-2006.

    PubMed

    Cogdill, Keith W; Ruffin, Angela B; Stavri, P Zoë

    2007-07-01

    The paper provides an overview of the National Network of Libraries of Medicine's (NN/ LM's) outreach to the public health workforce from 2001 to 2006. NN/LM conducts outreach through the activities of the Regional Medical Library (RML) staff and RML-sponsored projects led by NN/LM members. Between 2001 and 2006, RML staff provided training on information resources and information management for public health personnel at national, state, and local levels. The RMLs also contributed significantly to the Partners in Information Access for the Public Health Workforce collaboration. Data were extracted from telephone interviews with directors of thirty-seven NN/LM-sponsored outreach projects directed at the public health sector. A review of project reports informed the interviews, which were transcribed and subsequently coded for emergent themes using qualitative analysis software. Analysis of interview data led to the identification of four major themes: training, collaboration, evaluation of outcomes, and challenges. Sixteen subthemes represented specific lessons learned from NN/LM members' outreach to the public health sector. NN/LM conducted extensive information-oriented outreach to the public health workforce during the 2001-to-2006 contract period. Lessons learned from this experience, most notably the value of collaboration and the need for flexibility, continue to influence outreach efforts in the current contract period.

  5. The National Network of Libraries of Medicine's outreach to the public health workforce: 2001–2006

    PubMed Central

    Cogdill, Keith W.; Ruffin, Angela B.; Stavri, P. Zoë

    2007-01-01

    Objective: The paper provides an overview of the National Network of Libraries of Medicine's (NN/ LM's) outreach to the public health workforce from 2001 to 2006. Description: NN/LM conducts outreach through the activities of the Regional Medical Library (RML) staff and RML-sponsored projects led by NN/LM members. Between 2001 and 2006, RML staff provided training on information resources and information management for public health personnel at national, state, and local levels. The RMLs also contributed significantly to the Partners in Information Access for the Public Health Workforce collaboration. Methods: Data were extracted from telephone interviews with directors of thirty-seven NN/LM-sponsored outreach projects directed at the public health sector. A review of project reports informed the interviews, which were transcribed and subsequently coded for emergent themes using qualitative analysis software. Results: Analysis of interview data led to the identification of four major themes: training, collaboration, evaluation of outcomes, and challenges. Sixteen subthemes represented specific lessons learned from NN/LM members' outreach to the public health sector. Conclusions: NN/LM conducted extensive information-oriented outreach to the public health workforce during the 2001-to-2006 contract period. Lessons learned from this experience, most notably the value of collaboration and the need for flexibility, continue to influence outreach efforts in the current contract period. PMID:17641766

  6. Public apprehension of emerging infectious diseases: are changes afoot?

    PubMed

    Joffe, Helene

    2011-07-01

    Using social representations theory this paper casts light on the pattern of content that characterises the public response to emerging and re-emerging infectious diseases (EID). The pattern is: distancing the disease from the self/ one's in-groups; blame of particular entities for the disease's origin and/or spread; and stigmatisation of those who have contracted it and/or who are represented as having intensified its spread. This pattern is not unique to EID but extends to many risks, making EID fruitful events for understanding public apprehension of potential dangers. This process may be driven by worry, fear and anxiety since when levels of these are low, as has arguably been the case with the 2009/10 "Swine Flu" pandemic, the pattern transforms. The distancing-blame-stigma pattern may also be transformed by growing reflexivity, a feature of late modern societies, as well as material features of the epidemic and "EID fatigue".

  7. [Publications of medical thesis defended in Lille school of medicine].

    PubMed

    Benotmane, Ilies; Glatz, Nicolas; Bihan, Solenn; Legrand, Fanny; Gosset, Didier; Boulanger, Eric

    2012-07-01

    The purpose of this study was to determine the future, in terms of scientific publication, of medical thesis (MT) defended in the Medical School of Lille 2 University (MSL2U) between January 1st, 2001 and December 31st, 2007. The collection of MT published as a corresponding scientific article was realized from PubMed(®). For every corresponding article, we determined the journal Impact Factor (IF), the language of publication and the rank of the student and his MT director in the author list. Analyses were also realized according to the group of speciality of the TM. In all, 11.3% of the 2150 MT defended in the MSL2U were followed up by a scientific publication. The average IF was 2.32 with a median at 1.75 and extreme values from 0 to 14.78. Seventy percent of the articles were published in English. The rank of the student was placed before his MT director (2.06 vs. 3.15). The MT defended by students in the field of medical specialities presented the highest rate of publication (25.1%). The general medicine was the second speciality the most productive in term of number of published articles (n=49) after medical specialities (n=103). The MT director and the PhD students must be more motivated to publish their results. The value of 11.3% could be considered as weak but, because of a huge lack of references, it is impossible to compare our results to those of other French medical schools. It remains important to reform the objectives and the modalities of the writing of a MT: should we not have to turn to thesis called "on article"? Copyright © 2012. Published by Elsevier Masson SAS.

  8. Public Health Emergency Management Within the Department of Defense

    DTIC Science & Technology

    2010-03-05

    protected in accordance with applicable legal authorities including: (1) Sections 113, 3013, 5013, and 8013 of Reference (c), which generally...United States. c. The PHEO shall ascertain the existence of cases suggesting a public health emergency, ensure that sources of infection and/or...imprisonment for not more than 1 year, or both. In the case of military personnel, these potential sanctions are in addition to applicable military

  9. Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.

    PubMed

    Carpenter, Christopher R; Bromley, Marilyn; Caterino, Jeffrey M; Chun, Audrey; Gerson, Lowell W; Greenspan, Jason; Hwang, Ula; John, David P; Lyons, William L; Platts-Mills, Timothy F; Mortensen, Betty; Ragsdale, Luna; Rosenberg, Mark; Wilber, Scott

    2014-07-01

    In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and a strained health care system. In response, geriatric emergency medicine (EM) clinicians, educators, and researchers collaborated with the American College of Emergency Physicians (ACEP), American Geriatrics Society (AGS), Emergency Nurses Association (ENA), and the Society for Academic Emergency Medicine (SAEM) to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations; equipment; policies; and protocols. These "Geriatric Emergency Department Guidelines" represent the first formal society-led attempt to characterize the essential attribute of the geriatric ED and received formal approval from the boards of directors for each of the four societies in 2013 and 2014. This article is intended to introduce EM and geriatric health care providers to the guidelines, while providing proposals for educational dissemination, refinement via formal effectiveness evaluations and cost-effectiveness studies, and institutional credentialing.

  10. Public-private partnerships as driving forces in the quest for innovative medicines

    PubMed Central

    2013-01-01

    Background Despite progress in translational research, we are still falling short in developing the innovative medicines required to address major public health needs. Furthermore, the failure rate, time, and cost required for registration of a new drug are pushing the economics of the industry to the breaking point. New models of drug development based on collaborative endeavours are badly needed to improve this dire situation. Findings In 2004, the US Food and Drug Administration (FDA) introduced the Critical Path Initiative with the intent of modernizing drug development by implementing public-private partnerships (PPP) to share data, expertise, and resources. In response to FDA’s initiative, in the following year the non-profit Critical Path Institute (C-Path) was formed. At the same time, the National Institutes of Health (NIH) Public-Private Partnership program was established. In Europe, the Innovative Medicines Initiative (IMI) supported jointly by the European Union and the European Federation of Pharmaceutical Industries and Associations was launched in 2008. These independent efforts have a common long-term objective, namely to facilitate the emergence of innovative medicines by developing new tools for drug discovery, new indicators for drug efficacy or safety, and new approaches for patient stratification. Herein, we present evidence that PPP already exert a positive impact on the drug development process. Conclusions Public-private partnerships represent attractive means to leverage resources dispersed across industry, academia, and voluntary health organizations in order to address multiple challenges of drug development in an era of constrained resources and increased regulatory pressure. PMID:23369569

  11. An Emerging Role for Polystores in Precision Medicine

    SciTech Connect

    Gadapally, Vijay; Papadopoulus, Stavros; Begoli, Edmon; Christian, Blair

    2016-08-01

    Medical data is organically heterogeneous, and it usually varies significantly in both size and composition. Yet, this data is also a key for the recent and promising field of precision medicine, which focuses on identifying and tailoring appropriate medical treatments for the needs of the individual patients, based on their specific conditions, their medical history, lifestyle, genetic, and other individual factors. As we, and a database community at large, recognize that a ``one size does not fit all'' solution is required to work with such data, we present our observations based on our experiences, and the applications in the field of precision medicine. We make the case for the use of polystore architecture; how it applies for precision medicine; we discuss the reference architecture; describe some of its critical components (array database); and discuss the specific types of analysis that directly benefit from this database architecture, and the ways it serves the data.

  12. An Emerging Role for Polystores in Precision Medicine

    DOE PAGES

    Gadapally, Vijay; Papadopoulus, Stavros; Begoli, Edmon; ...

    2016-08-01

    Medical data is organically heterogeneous, and it usually varies significantly in both size and composition. Yet, this data is also a key for the recent and promising field of precision medicine, which focuses on identifying and tailoring appropriate medical treatments for the needs of the individual patients, based on their specific conditions, their medical history, lifestyle, genetic, and other individual factors. As we, and a database community at large, recognize that a ``one size does not fit all'' solution is required to work with such data, we present our observations based on our experiences, and the applications in the fieldmore » of precision medicine. We make the case for the use of polystore architecture; how it applies for precision medicine; we discuss the reference architecture; describe some of its critical components (array database); and discuss the specific types of analysis that directly benefit from this database architecture, and the ways it serves the data.« less

  13. Zika Virus: What Pediatric Emergency Medicine Physicians Need to Know.

    PubMed

    Blanco, Ashley; Chen, Lei

    2017-10-01

    Zika virus is a mosquito-borne Flavivirus. It has emerged as an important infectious agent in the recent past, mainly because of its teratogenic effects on the fetus. This review highlights the epidemiology, diagnosis, and treatment of this emerging infection.

  14. Protecting public health in the age of emerging infections.

    PubMed

    Lev, Ori; Rager-Zisman, Bracha

    2014-11-01

    Emerging and re-emerging infections cause huge concern among public health workers and international and national bodies such as the World Health Organization (WHO) and the U.S. National Institutes of Health (NIH). Indeed, scientists around the world express the view that despite the danger, research on these emerging virulent pathogens is crucial and must continue. While most of the studies underway are targeted at improving and protecting public health, some studies bear potentiallyserious risks resulting from misuse. These studies are defined as dual-use research of concern (DURC), where it is not evident that the benefits outweigh the risks. The H5N1 controversy has pushed various governments to institute new policies to govern such research. We describe the regulations that govern this emerging field of research in the United States and Israel, two countries that have taken leading stands on these issues. We suggest that the existing policies are able to mitigate many of the risks that this research encapsulates, yet more work is required--especially on the global level.

  15. Systematic Reviews Published in Emergency Medicine Journals Do Not Routinely Search Clinical Trials Registries: A Cross-Sectional Analysis.

    PubMed

    Keil, Lukas G; Platts-Mills, Timothy F; Jones, Christopher W

    2015-10-01

    Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials registry searches. We identified all systematic reviews published in the 6 highest-impact emergency medicine journals between January 1 and December 31, 2013. Systematic reviews that assessed the effects of an intervention were further examined to determine whether the authors described searching a clinical trials registry and whether this search identified relevant unpublished studies. Of 191 articles identified through PubMed search, 80 were confirmed to be systematic reviews. Our sample consisted of 41 systematic reviews that assessed a specific intervention. Eight of these 41 (20%) searched a clinical trials registry. For 4 of these 8 reviews, the registry search identified at least 1 relevant unpublished study. Systematic reviews published in emergency medicine journals do not routinely include searches of clinical trials registries. By helping authors identify unpublished trial data, the addition of registry searches may improve the validity of systematic reviews. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  16. Alternative medicines as emerging therapies for inflammatory bowel diseases.

    PubMed

    Singh, Udai P; Singh, Narendra P; Busbee, Brandon; Guan, H; Singh, Balwan; Price, Robert L; Taub, Dennis D; Mishra, Manoj K; Nagarkatti, Mitzi; Nagarkatti, Prakash S

    2012-02-01

    Inflammatory bowel disease (IBD) can be divided into two major categories, ulcerative colitis (UC) and Crohn disease (CD). While the main cause(s) of IBD remain unknown, a number of interventional and preventive strategies have been proposed for use against CD and UC. Many reports have focused on the use of alternative natural medicines as potential therapeutic interventions in IBD patients with minimal side effects. While the use of alternative medicines may be effective in IBD patients that are refractory to corticosteroids or thiopurins, alternative treatment strategies are limited and require extensive clinical testing before being optimized for use in patients.

  17. State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model.

    PubMed

    Mbanjumucyo, Gabin; DeVos, Elizabeth; Pulfrey, Simon; Epino, Henry M

    2015-01-01

    The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda's referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda's first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country's district hospitals. While there has been early vital progress in building emergency medicine's foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country's healthcare and emergency medicine leaders.

  18. Reporting Guidelines: Optimal Use in Preventive Medicine and Public Health

    PubMed Central

    Popham, Karyn; Calo, William A.; Carpentier, Melissa Y.; Chen, Naomi E.; Kamrudin, Samira A.; Le, Yen-Chi L.; Skala, Katherine A.; Thornton, Logan R.; Mullen, Patricia Dolan

    2012-01-01

    Numerous reporting guidelines are available to help authors write higher quality manuscripts more efficiently. Almost 200 are listed on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network’s website and they vary in authority, usability, and breadth, making it difficult to decide which one(s) to use. This paper provides consistent information about guidelines for preventive medicine and public health and a framework and sequential approach for selecting them. EQUATOR guidelines were reviewed for relevance to target audiences; selected guidelines were classified as “core” (frequently recommended) or specialized, and the latter were grouped by their focus. Core and specialized guidelines were coded for indicators of authority (simultaneous publication in multiple journals, rationale, scientific background supporting each element, expertise of designers, permanent website/named group), usability (presence of checklists and examples of good reporting), and breadth (manuscript sections covered). Discrepancies were resolved by consensus. Selected guidelines are presented in four tables arranged to facilitate selection: core guidelines, all of which pertain to major research designs; guidelines for additional study designs, topical guidelines, and guidelines for particular manuscript sections. A flow diagram provides an overview. The framework and sequential approach will enable authors as well as editors, peer reviewers, researchers, and systematic reviewers to make optimal use of available guidelines to improve the transparency, clarity, and rigor of manuscripts and research protocols and the efficiency of conducing systematic reviews and meta-analyses. PMID:22992369

  19. Law Enforcement and Emergency Medicine: An Ethical Analysis.

    PubMed

    Baker, Eileen F; Moskop, John C; Geiderman, Joel M; Iserson, Kenneth V; Marco, Catherine A; Derse, Arthur R

    2016-11-01

    Emergency physicians frequently interact with law enforcement officers and patients in their custody. As always, the emergency physician's primary professional responsibility is to promote patient welfare, and his or her first duty is to the patient. Emergency physicians should treat criminals, suspects, and prisoners with the same respect and attention they afford other patients while ensuring the safety of staff, visitors, and other patients. Respect for patient privacy and protection of confidentiality are of paramount importance to the patient-physician relationship. Simultaneously, emergency physicians should attempt to accommodate law enforcement personnel in a professional manner, enlisting their aid when necessary. Often this relates to the emergency physician's socially imposed duties, governed by state laws, to report infectious diseases, suspicion of abuse or neglect, and threats of harm. It is the emergency physician's duty to maintain patient confidentiality while complying with Health Insurance Portability and Accountability Act regulations and state law. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  20. Narrowing the gap of personalized medicine in emerging countries: the case of multiple endocrine neoplasias in Brazil.

    PubMed

    Toledo, Rodrigo A; Sekiya, Tomoko; Longuini, Viviane C; Coutinho, Flavia L; Lourenço, Delmar M; Toledo, Sergio P A

    2012-01-01

    The finished version of the human genome sequence was completed in 2003, and this event initiated a revolution in medical practice, which is usually referred to as the age of genomic or personalized medicine. Genomic medicine aims to be predictive, personalized, preventive, and also participative (4Ps). It offers a new approach to several pathological conditions, although its impact so far has been more evident in mendelian diseases. This article briefly reviews the potential advantages of this approach, and also some issues that may arise in the attempt to apply the accumulated knowledge from genomic medicine to clinical practice in emerging countries. The advantages of applying genomic medicine into clinical practice are obvious, enabling prediction, prevention, and early diagnosis and treatment of several genetic disorders. However, there are also some issues, such as those related to: (a) the need for approval of a law equivalent to the Genetic Information Nondiscrimination Act, which was approved in 2008 in the USA; (b) the need for private and public funding for genetics and genomics; (c) the need for development of innovative healthcare systems that may substantially cut costs (e.g. costs of periodic medical followup); (d) the need for new graduate and postgraduate curricula in which genomic medicine is emphasized; and (e) the need to adequately inform the population and possible consumers of genetic testing, with reference to the basic aspects of genomic medicine.

  1. Narrowing the gap of personalized medicine in emerging countries: the case of multiple endocrine neoplasias in Brazil

    PubMed Central

    Toledo, Rodrigo A.; Sekiya, Tomoko; Longuini, Viviane C.; L. Coutinho, Flavia; Lourenço, Delmar M.; Toledo, Sergio P. A.

    2012-01-01

    The finished version of the human genome sequence was completed in 2003, and this event initiated a revolution in medical practice, which is usually referred to as the age of genomic or personalized medicine. Genomic medicine aims to be predictive, personalized, preventive, and also participative (4Ps). It offers a new approach to several pathological conditions, although its impact so far has been more evident in mendelian diseases. This article briefly reviews the potential advantages of this approach, and also some issues that may arise in the attempt to apply the accumulated knowledge from genomic medicine to clinical practice in emerging countries. The advantages of applying genomic medicine into clinical practice are obvious, enabling prediction, prevention, and early diagnosis and treatment of several genetic disorders. However, there are also some issues, such as those related to: (a) the need for approval of a law equivalent to the Genetic Information Nondiscrimination Act, which was approved in 2008 in the USA; (b) the need for private and public funding for genetics and genomics; (c) the need for development of innovative healthcare systems that may substantially cut costs (e.g. costs of periodic medical follow-up); (d) the need for new graduate and postgraduate curricula in which genomic medicine is emphasized; and (e) the need to adequately inform the population and possible consumers of genetic testing, with reference to the basic aspects of genomic medicine. PMID:22584698

  2. Antimicrobial resistance: A global emerging threat to public health systems.

    PubMed

    Ferri, Maurizio; Ranucci, Elena; Romagnoli, Paola; Giaccone, Valerio

    2017-09-02

    Antimicrobial resistance (AMR) became in the last two decades a global threat to public health systems in the world. Since the antibiotic era, with the discovery of the first antibiotics that provided consistent health benefits to human medicine, the misuse and abuse of antimicrobials in veterinary and human medicine have accelerated the growing worldwide phenomenon of AMR. This article presents an extensive overview of the epidemiology of AMR, with a focus on the link between food producing-animals and humans and on the legal framework and policies currently implemented at the EU level and globally. The ways of responding to the AMR challenges foresee an array of measures that include: designing more effective preventive measures at farm level to reduce the use of antimicrobials; development of novel antimicrobials; strengthening of AMR surveillance system in animal and human populations; better knowledge of the ecology of resistant bacteria and resistant genes; increased awareness of stakeholders on the prudent use of antibiotics in animal productions and clinical arena; and the public health and environmental consequences of AMR. Based on the global nature of AMR and considering that bacterial resistance does not recognize barriers and can spread to people and the environment, the article ends with specific recommendations structured around a holistic approach and targeted to different stakeholders.

  3. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  4. FOAMSearch.net: A custom search engine for emergency medicine and critical care.

    PubMed

    Raine, Todd; Thoma, Brent; Chan, Teresa M; Lin, Michelle

    2015-08-01

    The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  5. Genomics, public health and developing countries: the case of the Mexican National Institute of Genomic Medicine (INMEGEN).

    PubMed

    Séguin, Béatrice; Hardy, Billie-Jo; Singer, Peter A; Daar, Abdallah S

    2008-10-01

    In 2004, the government of Mexico established the National Institute of Genomic Medicine (INMEGEN), to carry out disease-related genomic studies that will address national health problems and stimulate scientific and technological development by generating new commercial products and services in genomic medicine. Towards this end, INMEGEN is carrying out a large-scale genotyping project to map genomic variation within its own population. The initiative is expected to generate a key resource for local researchers to understand disease susceptibility and variation in drug responses, which will contribute to Mexico's goal of developing public health genomics - a field in which Mexico is proving to be a leader amongst emerging economies.

  6. Non-publication and publication bias in reproductive medicine: a cohort analysis.

    PubMed

    Lensen, S; Jordan, V; Showell, M; Showell, E; Shen, V; Venetis, C; Farquhar, C

    2017-08-01

    Does publication bias or non-publication exist in fertility trials presented as conference abstracts? This study did not detect any publication bias; however, it did identify a high level of non-publication, with only 49% of abstracts reaching full-text publication four or more years after abstract presentation. Systematic reviews of randomized controlled trials (RCTs) are the foundation of evidence based medicine. Non-publication or publication deficit refer to the failure to publish trial results. A publication bias exists when there is any tendency on the parts of the investigators or editors to fail to publish study results on the basis or strength of the study findings. Both present a serious problem for researchers, clinicians and policymakers alike, and ultimately impact on patient care. A retrospective cohort study identified 337 fertility RCTs presented as conference abstracts between 2007 and 2010, as captured by an electronic search of the Cochrane Gynaecology and Fertility Database. After excluding ineligible trials and duplicates, 224 abstracts remained. A search for the full-text papers of each abstract was undertaken in Pubmed, MEDLINE, Embase, CINAHL and Google in May 2015 using a probabilistic approach. Trial authors were contacted to query the publication status of abstracts when no full-text was identified. The association between individual variables and the probability of publication, and time to publication, was assessed using logistic regression and Cox regression, respectively. Of the 224 included abstracts, only 110 (49%; 95% CI: 42.6, 55.6) were found to be published as full-text articles. Publication bias was not identified in this cohort; studies with positive results had a similar probability of reaching full-text publication 52/113 (46%; 95% CI: 37.0, 55.3) as studies with non-positive (negative or null) results 58/111 (52%; 95% CI: 17.8, 33.9) (adjusted odds ratio (AOR): 1.02; 95% CI: 0.53, 1.97). Similarly, the time from abstract

  7. Consensus-Based Recommendations for an Emergency Medicine Pain Management Curriculum.

    PubMed

    Poon, Sabrina J; Nelson, Lewis S; Hoppe, Jason A; Perrone, Jeanmarie; Sande, Margaret K; Yealy, Donald M; Beeson, Michael S; Todd, Knox H; Motov, Sergey M; Weiner, Scott G

    2016-08-01

    Increased prescribing of opioid pain medications has paralleled the subsequent rise of prescription medication-related overdoses and deaths. We sought to define key aspects of a pain management curriculum for emergency medicine (EM) residents that achieve the balance between adequate pain control, limiting side effects, and not contributing to the current public health opioid crisis. We convened a symposium to discuss pain management education in EM and define the needs and objectives of an EM-specific pain management curriculum. Multiple pertinent topics were identified a priori and presented before consensus work. Subgroups then sought to define perceived gaps and needs, to set a future direction for development of a focused curriculum, and to prioritize the research needed to evaluate and measure the impact of a new curriculum. The group determined that an EM pain management curriculum should include education on both opioid and nonopioid analgesics as well as nonpharmacologic pain strategies. A broad survey is needed to better define current knowledge gaps and needs. To optimize the impact of any curriculum, a modular, multimodal, and primarily case-based approach linked to achieving milestones is best. Subsequent research should focus on the impact of curricular reform on learner knowledge and patient outcomes, not just prescribing changes. This consensus group offers a path forward to enhance the evidence, knowledge, and practice transformation needed to improve emergency analgesia. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey.

    PubMed

    Cevik, Erdem; Karakus Yilmaz, Banu; Acar, Yahya Ayhan; Dokur, Mehmet

    2015-03-01

    The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education). Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1%) of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88) were animal studies. It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E.

  9. National Health and Hospital Network for Australia's future: implications for Emergency Medicine.

    PubMed

    FitzGerald, Gerry; Ashby, Richard

    2010-10-01

    The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care. © 2010 The Authors. Emergency Medicine Australasia © 2010 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. Assessing integration of clinical and public health skills in preventive medicine residencies: using competency mapping.

    PubMed

    Wells, Eden V; Sarigiannis, Amy N; Boulton, Matthew L

    2012-06-01

    To evaluate the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice's Tier-2 Core Competencies for Public Health Professionals. CHC learning objectives mapped to all four (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Utilizing competency mapping to assess clinical-public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. GeoSentinel: the global emerging infections sentinel network of the International Society of Travel Medicine.

    PubMed

    Freedman, D O; Kozarsky, P E; Weld, L H; Cetron, M S

    1999-06-01

    GeoSentinel is a network of 22 member travel/tropical medicine clinics (14 in the United States and 8 in other countries) initiated in 1995 by the International Society of Travel Medicine (ISTM). GeoSentinel is based on the concept that these clinics are ideally situated to effectively detect geographic and temporal trends in morbidity among travelers. The core surveillance tool is a single-page faxable form submitted to a central data site for each post-travel patient, including immigrants, refugees, and foreign visitors. Diagnoses are entered either as specific etiologies or as syndromes and are then linked to geographic locations, reference dates, and clinical presentations. In addition, electronic communication with the larger body of worldwide ISTM member clinics is periodically done to obtain broader data collection in response to specific inquiries. The scope of GeoSentinel has broadened from the initial vision of a provider-based sentinel network tracking emerging infections at their point of entry into developed countries. Its present goals are (1) to monitor global trends in disease occurrence among travelers; (2) to ascertain risk factors and morbidity in groups of travelers categorized by travel purpose and type of traveler; (3) to respond to urgent public health queries; (4) to develop educational priorities for travelers' health; and (5) to effect a rapid response by electronically disseminating alerts to surveillance sites, to all ISTM members in 55 countries, and to public health authorities. In addition, a major byproduct of the network, and now one of its strongest assets, has been the growth of partnerships between ISTM, Centers for Disease Control and Prevention and health-care providers around the world, as well as other medical societies, government, and private organizations. The demographic data, travel patterns, and clinical presentations for the first 2813 patient records analyzed from the GeoSentinel sites are summarized in this paper.

  12. National Differences in Regional Emergency Department Boarding Times: Are US Emergency Departments Prepared for a Public Health Emergency?

    PubMed

    Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G

    2016-08-01

    Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).

  13. Just allocation and team loyalty: a new virtue ethic for emergency medicine

    PubMed Central

    Girod, J; Beckman, A

    2005-01-01

    When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595

  14. Generational influences in academic emergency medicine: structure, function, and culture (Part II).

    PubMed

    Mohr, Nicholas M; Smith-Coggins, Rebecca; Larrabee, Hollynn; Dyne, Pamela L; Promes, Susan B

    2011-02-01

    Strategies for approaching generational issues that affect teaching and learning, mentoring, and technology in emergency medicine (EM) have been reported. Tactics to address generational influences involving the structure and function of the academic emergency department (ED), organizational culture, and EM schedule have not been published. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic EM. Understanding generational characteristics and mitigating strategies can address some common issues encountered in academic EM. By understanding the differences and strengths of each of the cohorts in academic EM departments and considering simple mitigating strategies, faculty leaders can maximize their cooperative effectiveness and face the challenges of a new millennium. © 2011 by the Society for Academic Emergency Medicine.

  15. Public Health in the Emergency Department: Overcoming Barriers to Implementation and Dissemination

    PubMed Central

    McKay, Mary Pat; Vaca, Federico E.; Field, Craig; Rhodes, Karin

    2011-01-01

    This article is the outcome of a consensus building workshop entitled, “Overcoming Barriers to Implementation and Dissemination” convened at the 2009 Academic Emergency Medicine Consensus Conference, “Public Health in the ED: Surveillance, Screening, and Intervention.” The participants were asked to address potential methods for overcoming barriers to the dissemination and implementation in the emergency department (ED) of evidenced-based practices to improve public health. The panel discussed three broad areas of interest including methods for disseminating evidence-based practices, barriers encountered during the process of implementation, and the importance of involvement in activities outside the ED including engagement in policy development and improvement. Four recommendations were discussed in detail and consensus was reached. The recommendations included 1) researchers and advocates should disseminate findings through multiple forums beyond peer-reviewed publications when an ED-based public health intervention has enough evidence to support integration into the routine practice of emergency care; 2) local barriers to implementation of public health interventions should be recognized and well understood from multiple perspectives prior to implementation; 3) innovation must be put into place and adapted based on local institutional context and culture as barriers and the best methods for overcoming them will vary across institutions; and 4) use of legislation, regulation, and incentives outside of the ED should support and strengthen ED-based interventions. For each area of interest, research dimensions to extend the current understanding of methods for effectively and efficiently implementing evidence-based public health interventions in the ED were discussed and consensus was achieved. PMID:20053233

  16. Education scholarship in emergency medicine part 3: a "how-to" guide.

    PubMed

    Bhanji, Farhan; Cheng, Adam; Frank, Jason R; Snell, Linda; Sherbino, Jonathan

    2014-05-01

    Successful emergency medicine (EM) education scholarship requires a systematic approach that includes searching the (grey) literature, mobilizing resources, adopting frameworks to focus the innovation, integrating a component of program evaluation, and disseminating the innovation via traditional and emerging avenues. This paper provides direction for EM teachers and educators looking to transform their education innovation into scholarship. Recommendations on producing EM education scholarship from the 2013 consensus conference of the Academic Section of the Canadian Association of Emergency Physicians are presented.

  17. [Psychiatric Emergencies in the Preclinical Emergency Medicine Service in Ulm, Germany in 2000 and 2010, and Practical Consequences].

    PubMed

    Schönfeldt-Lecuona, Carlos; Gahr, Maximilian; Schütz, Stefan; Lang, Dirk; Pajonk, Frank Gerald Bernhard; Connemann, Bernhard J; Muth, Claus-Martin; Freudenmann, Roland W

    2017-07-01

    Background Psychiatric emergencies (PE) in preclinical emergency medical services are about 5 - 10 % of all emergencies and represent often a source of difficulties in handling for the non-psychiatric professional helpers that deal with them. Studies informing about quantitative and qualitative changes of PEs in preclinical emergency medicine in Germany are scarce. Methods Therefore, we conducted a retrospective cross-sectional study of PE in a preclinical emergency medical service based on the protocols of the emergency ambulance of the Section for Emergency Medicine at the University Hospital Ulm comparing the years 2000 and 2010. Results We observed a significant increase of PEs from 8.8 % in the year 2000 (n = 285, from a total of n = 3227) to 10.3 % in 2010 (n = 454, from a total of n = 4425). In both years intoxications were the most common PE [2000: n = 116 (44.4 %); 2010: n = 171 (37.7 %)], followed by suicide-related behavior [2000: n = 59 (22.6 %); 2010: n = 78 (17.2 %)] and acute anxiety disorders [2000: n = 37 (13 %); 2010: n = 105 (23.1 %)]. The mentioned three conditions accounted for about 80 % of all PE. Most frequently PE occurred at the weekend and with the highest density in the evening and at night (18 - 24 h) in both years. Patients with PE were predominantly men, but the rate of women causing PE increased between 2000 and 2010. Discussion/Conclusion This study provides preliminary data on current trends in PEs in preclinical emergency medicine in Germany and has implications for improving the medical care provided. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Emergency medicine in Cuba: report from a country in isolation.

    PubMed

    Richards, J R

    1997-07-01

    Cuba is one of the poorest countries of the world. For the past 34 years the United States has maintained an economic embargo against Cuba. Because of this, Cuba has not been able to share in advances in American medical technology, pharmaceuticals, or research. The country has also been abandoned by the former Soviet Union. Recent political developments have assured continuation of the embargo. This report describes the current state of prehospital and emergency medical care in Cuba, how the embargo has affected emergency services, and possibilities for the future.

  19. Preventive medicine and public health residency training: federal policy and advocacy opportunities.

    PubMed

    Brenner, Sara; Siu, Kimberly

    2009-11-01

    Preventive medicine physicians are uniquely trained in both clinical medicine and public health to understand and reduce the risks of disease, disability, and death in individuals and populations. The nation is facing a severe shortage of preventive medicine-trained physicians, which is largely due to unstable and inadequate residency program funding. Several policy options have been explored and evaluated to fund preventive medicine residency training programs as part of a multipronged approach to engage physicians in the policy-making process. The most adequate, sustainable, distributable, and politically feasible policy option was pursued, and a bill called the "Preventive Medicine and Public Health Training Act" was introduced into the House and the Senate. Opportunities to participate in the policy-making process and interact with key legislators and stakeholders exist in a variety of ways. Leadership at the federal level helps preventive medicine and public health physicians recognize their vital role in shaping public policy.

  20. Rural GPs' attitudes toward participating in emergency medicine: a qualitative study.

    PubMed

    Hjortdahl, Magnus; Halvorsen, Peder; Risør, Mette Bech

    2016-12-01

    Health authorities want to increase general practitioner (GP) participation in emergency medicine, but the role of the GP in this context controversial. We explored GPs' attitudes toward emergency medicine and call outs. Thematic analysis of focus group interviews. Four rural casualty clinics in Norway. GPs with experience ranging from one to 32 years. The GPs felt that their role had changed from being the only provider of emergency care to being one of many. In particular, the emergency medical technician teams (EMT) have evolved and often manage well without a physician. Consequently, the GPs get less experience and feel more uncertain when encountering emergencies. Nevertheless, the GPs want to participate in call outs. They believed that their presence contributes to better patient care, and the community appreciates it. Taking part in call outs is seen as being vital to maintaining skills. The GPs had difficulties explaining how to decide whether to participate in call outs. Decisions were perceived as difficult due to insufficient information. The GPs assessed factors, such as distance from the patient and crowding at the casualty clinic, differently when discussing participation in call outs. Although their role may have changed, GPs argue that they still play a part in emergency medicine. The GPs claim that by participating in call outs, they maintain their skills and improve patient care, but further research is needed to help policy makers and clinicians decide when the presence of a GP really counts. Norwegian health authorities want to increase participation by general practitioners (GPs) in emergency medicine, but the role of the GP in this context is controversial. KEY POINTS The role of the GP has changed, but GPs argue that they still play an important role in emergency medicine. GPs believe that their presence on call outs improve patient care, but they find it defensible that patients are tended to by emergency medical technicians (EMTs) only

  1. Marketing and public relations in the emergency department.

    PubMed

    Mayer, T A; Tilson, W; Hemingway, J

    1987-02-01

    This article outlines the elements of successful ED marketing, as well as providing definitions for terms used within the marketing process. In today's competition and rapidly changing environment, marketing and public relations are tools that every ED Medical Director may want to consider. Because the marketing process requires a great deal of time and effort, as well as a high degree of intellectual honesty, it should never be entered into without a strong commitment. However, marketing the ED can be among the most productive, stimulating, and gratifying experiences for the ED Medical Director, the emergency department physicians, and all ED service personnel.

  2. Public/private interactions during emergency preparedness situations.

    PubMed

    O'Reilly, William J

    2007-01-01

    The establishment of person to person communications between first responders in both the public and private sectors in advance of an emergency is essential to avoid a catastrophic outcome, according to the author, a member of the Homeland Security Unit of the Chicago. IL, Police Department. He stresses that 85 % of the country's critical infrastructure is protected by private security. Establishing who the key points of contact are at each of the responder disciplines must be inherent in all pre-operations planning, he points out.

  3. Ethics of clinical science in a public health emergency: drug discovery at the bedside.

    PubMed

    Edwards, Sarah J L

    2013-01-01

    Clinical research under the usual regulatory constraints may be difficult or even impossible in a public health emergency. Regulators must seek to strike a good balance in granting as wide therapeutic access to new drugs as possible at the same time as gathering sound evidence of safety and effectiveness. To inform current policy, I reexamine the philosophical rationale for restricting new medicines to clinical trials, at any stage and for any population of patients (which resides in the precautionary principle), to show that its objective to protect public health, now or in the future, could soon be defeated in a pandemic. Providing wider therapeutic access and coordinating observations and natural experiments, including service delivery by cluster (wedged cluster trials), may provide such a balance. However, there are important questions of fairness to resolve before any such research can proceed.

  4. Ethics of Clinical Science in a Public Health Emergency: Drug Discovery at the Bedside

    PubMed Central

    2013-01-01

    Clinical research under the usual regulatory constraints may be difficult or even impossible in a public health emergency. Regulators must seek to strike a good balance in granting as wide therapeutic access to new drugs as possible at the same time as gathering sound evidence of safety and effectiveness. To inform current policy, I reexamine the philosophical rationale for restricting new medicines to clinical trials, at any stage and for any population of patients (which resides in the precautionary principle), to show that its objective to protect public health, now or in the future, could soon be defeated in a pandemic. Providing wider therapeutic access and coordinating observations and natural experiments, including service delivery by cluster (wedged cluster trials), may provide such a balance. However, there are important questions of fairness to resolve before any such research can proceed. PMID:23952822

  5. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health.

    PubMed

    Trzeciak, S; Rivers, E P

    2003-09-01

    Numerous reports have questioned the ability of United States emergency departments to handle the increasing demand for emergency services. Emergency department (ED) overcrowding is widespread in US cities and has reportedly reached crisis proportions. The purpose of this review is to describe how ED overcrowding threatens patient safety and public health, and to explore the complex causes and potential solutions for the overcrowding crisis. A review of the literature from 1990 to 2002 identified by a search of the Medline database was performed. Additional sources were selected from the references of the articles identified. There were four key findings. (1) The ED is a vital component of America's health care "safety net". (2) Overcrowding in ED treatment areas threatens public health by compromising patient safety and jeopardising the reliability of the entire US emergency care system. (3) Although the causes of ED overcrowding are complex, the main cause is inadequate inpatient capacity for a patient population with an increasing severity of illness. (4) Potential solutions for ED overcrowding will require multidisciplinary system-wide support.

  6. Emerging strategies for exploiting cannabinoid receptor agonists as medicines.

    PubMed

    Pertwee, Roger G

    2009-02-01

    Medicines that activate cannabinoid CB(1) and CB(2) receptor are already in the clinic. These are Cesamet (nabilone), Marinol (dronabinol; Delta(9)-tetrahydrocannabinol) and Sativex (Delta(9)-tetrahydrocannabinol with cannabidiol). The first two of these medicines can be prescribed to reduce chemotherapy-induced nausea and vomiting. Marinol can also be prescribed to stimulate appetite, while Sativex is prescribed for the symptomatic relief of neuropathic pain in adults with multiple sclerosis and as an adjunctive analgesic treatment for adult patients with advanced cancer. One challenge now is to identify additional therapeutic targets for cannabinoid receptor agonists, and a number of potential clinical applications for such agonists are mentioned in this review. A second challenge is to develop strategies that will improve the efficacy and/or the benefit-to-risk ratio of a cannabinoid receptor agonist. This review focuses on five strategies that have the potential to meet either or both of these objectives. These are strategies that involve: (i) targeting cannabinoid receptors located outside the blood-brain barrier; (ii) targeting cannabinoid receptors expressed by a particular tissue; (iii) targeting up-regulated cannabinoid receptors; (iv) targeting cannabinoid CB(2) receptors; or (v) 'multi-targeting'. Preclinical data that justify additional research directed at evaluating the clinical importance of each of these strategies are also discussed.

  7. Emerging strategies for exploiting cannabinoid receptor agonists as medicines

    PubMed Central

    Pertwee, Roger G

    2009-01-01

    Medicines that activate cannabinoid CB1 and CB2 receptor are already in the clinic. These are Cesamet® (nabilone), Marinol® (dronabinol; Δ9-tetrahydrocannabinol) and Sativex® (Δ9-tetrahydrocannabinol with cannabidiol). The first two of these medicines can be prescribed to reduce chemotherapy-induced nausea and vomiting. Marinol® can also be prescribed to stimulate appetite, while Sativex® is prescribed for the symptomatic relief of neuropathic pain in adults with multiple sclerosis and as an adjunctive analgesic treatment for adult patients with advanced cancer. One challenge now is to identify additional therapeutic targets for cannabinoid receptor agonists, and a number of potential clinical applications for such agonists are mentioned in this review. A second challenge is to develop strategies that will improve the efficacy and/or the benefit-to-risk ratio of a cannabinoid receptor agonist. This review focuses on five strategies that have the potential to meet either or both of these objectives. These are strategies that involve: (i) targeting cannabinoid receptors located outside the blood-brain barrier; (ii) targeting cannabinoid receptors expressed by a particular tissue; (iii) targeting up-regulated cannabinoid receptors; (iv) targeting cannabinoid CB2 receptors; or (v) ‘multi-targeting’. Preclinical data that justify additional research directed at evaluating the clinical importance of each of these strategies are also discussed. PMID:19226257

  8. Assessing integration of clinical and public health skills in preventive medicine residencies: using competency mapping.

    PubMed

    Wells, Eden V; Sarigiannis, Amy N; Boulton, Matthew L

    2012-06-01

    We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice's tier 2 Core Competencies for Public Health Professionals. CHC learning objectives mapped to all 4 (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Utilizing competency mapping to assess clinical-public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies.

  9. Assessing Integration of Clinical and Public Health Skills in Preventive Medicine Residencies: Using Competency Mapping

    PubMed Central

    Sarigiannis, Amy N.; Boulton, Matthew L.

    2012-01-01

    Objectives. We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Methods. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice’s tier 2 Core Competencies for Public Health Professionals. Results. CHC learning objectives mapped to all 4 (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Conclusions. Utilizing competency mapping to assess clinical–public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies. PMID:22690972

  10. Promoting diversity in emergency medicine: summary recommendations from the 2008 Council of Emergency Medicine Residency Directors (CORD) Academic Assembly Diversity Workgroup.

    PubMed

    Heron, Sheryl L; Lovell, Elise O; Wang, Ernest; Bowman, Steven H

    2009-05-01

    Although the U.S. population continues to become more diverse, ethnic and racial health care disparities persist. The benefits of a diverse medical workforce have been well described, but the percentage of emergency medicine (EM) residents from underrepresented groups (URGs) is small and has not significantly increased over the past 10 years. The Council of Emergency Medicine Resident Directors (CORD) requested that a panel of CORD members review the current state of ethnic and racial diversity in EM training programs. The objective of the discussion was to develop strategies to help EM residency programs examine and improve diversity in their respective institutions. Specific recommendations focus on URG applicant selection and recruitment strategies, cultural competence curriculum development, involvement of URG faculty, and the availability of institutional and national resources to improve and maintain diversity in EM training programs.

  11. Emerging concepts in pancreatic cancer medicine: targeting the tumor stroma

    PubMed Central

    Neesse, Albrecht; Krug, Sebastian; Gress, Thomas M; Tuveson, David A; Michl, Patrick

    2014-01-01

    Pancreatic ductal adenocarcinoma is a stroma-rich and highly challenging cancer to treat. Over recent years, it has become increasingly evident that the complex network of soluble cytokines, growth factors, proteases, and components of the extracellular matrix collaboratively interact within the tumor microenvironment, sustaining and driving cancer cell proliferation, invasion, and early metastasis. More recently, the tumor microenvironment has also been appreciated to mediate therapeutic resistance in pancreatic ductal adenocarcinoma, thus opening numerous avenues for novel therapeutic explorations. Inert and soluble components of the tumor stroma have been targeted in order to break down the extracellular matrix scaffold, relieve vessel compression, and increase drug delivery to hypovascular tumors. Moreover, targeting of antiapoptotic, immunosuppressive, and pro-proliferative effects of the tumor stroma provides novel vantage points of attack. This review focuses on current and future developments in pancreatic cancer medicine, with a particular emphasis on biophysical and biochemical approaches that target the tumor microenvironment. PMID:24379681

  12. Global Emergency Medicine Journal Club: A Social Media Discussion About the Lack of Association Between Press Ganey Scores and Emergency Department Analgesia.

    PubMed

    Westafer, Lauren; Hensley, Justin; Shaikh, Sameed; Lin, Michelle

    2016-01-01

    Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host a public discussion featuring the 2014 Annals article on the association between Press Ganey scores and emergency department (ED) analgesia by Schwartz et al. The objective was to curate a 14-day (December 1 through 14, 2014) worldwide academic dialogue among clinicians in regard to preselected questions about the article. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions. Engagement was tracked through Web analytic tools and analysis of tweets. Blog comments, tweets, and video expert commentary involving the featured article are summarized and reported. The dialogue resulted in 978 page views from 342 cities in 33 countries on the ALiEM Web site, 464,345 Twitter impressions, and 83 views of the video interview with experts. Of the unique 169 identified tweets, discussion (53.3%) and learning points (32.5%) were the most common category of tweets identified. Common themes that arose in the open-access multimedia discussions included Press Ganey data validity and the utility of patient satisfaction in determining pain treatment efficacy. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide scholarly discourse.

  13. The development of the specialism of emergency medicine: media and cultural influences.

    PubMed

    Timmons, Stephen; Nairn, Stuart

    2015-01-01

    In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources.

  14. Developing technical expertise in emergency medicine--the role of simulation in procedural skill acquisition.

    PubMed

    Wang, Ernest E; Quinones, Joshua; Fitch, Michael T; Dooley-Hash, Suzanne; Griswold-Theodorson, Sharon; Medzon, Ron; Korley, Frederick; Laack, Torrey; Robinett, Adam; Clay, Lamont

    2008-11-01

    Developing technical expertise in medical procedures is an integral component of emergency medicine (EM) practice and training. This article is the work of an expert panel composed of members from the Society for Academic Emergency Medicine (SAEM) Interest Group, the SAEM Technology in Medical Education Committee, and opinions derived from the May 2008 Academic Emergency Medicine Consensus Conference, "The Science of Simulation in Healthcare." The writing group reviewed the simulation literature on procedures germane to EM training, virtual reality training, and instructional learning theory as it pertains to skill acquisition and procedural skills decay. The authors discuss the role of simulation in teaching technical expertise, identify training conditions that lead to effective learning, and provide recommendations for future foci of research.

  15. A suggested core content for education scholarship fellowships in emergency medicine.

    PubMed

    Yarris, Lalena M; Coates, Wendy C; Lin, Michelle; Lind, Karen; Jordan, Jaime; Clarke, Sam; Guth, Todd A; Santen, Sally A; Hamstra, Stanley J

    2012-12-01

    A working group at the 2012 Academic Emergency Medicine consensus conference on education research in emergency medicine (EM) convened to develop a curriculum for dedicated postgraduate fellowships in EM education scholarship. This fellowship is intended to create future education scholars, equipped with the skills to thrive in academic careers. This proceedings article reports on the consensus of a breakout session subgroup tasked with defining a common core content for education scholarship fellowships. The authors propose that the core content of an EM education scholarship fellowship can be categorized in four distinct areas: career development, theories of learning and teaching methods, education research methods, and educational program administration. This core content can be incorporated into curricula for education scholarship fellowships in EM or other fields and can also be adapted for use in general medical education fellowships. © 2012 by the Society for Academic Emergency Medicine.

  16. The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health.

    PubMed

    Pillai, Satish K; Beekmann, Susan E; Santibanez, Scott; Polgreen, Philip M

    2014-04-01

    In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN.

  17. The Infectious Diseases Society of America Emerging Infections Network: Bridging the Gap Between Clinical Infectious Diseases and Public Health

    PubMed Central

    Pillai, Satish K.; Beekmann, Susan E.; Santibanez, Scott; Polgreen, Philip M.

    2015-01-01

    In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN. PMID:24403542

  18. New glossary of terms used in regenerative medicine: standardization continues to emerge as regenerative medicine matures.

    PubMed

    Sheridan, Ben; Harris, Neil

    2009-07-01

    Regenerative medicine is an evolving, cross-disciplinary, international field that, as a result, uses terms that are either not widely understood, or may have a number of different meanings. Many stakeholders have identified this lack of clarity as a potential barrier to effective communication within the field. To address this, BSI British Standards, supported by the UK Department for Innovation, Universities and Skills (DIUS), was commissioned to develop guidance on the definitions of terms used within regenerative medicine. The resulting document aims to provide clear consensus terminology to improve communication and facilitate a common understanding for a broad range of potential users.

  19. Space shuttle operations at the NASA Kennedy Space Center: the role of emergency medicine

    NASA Technical Reports Server (NTRS)

    Rodenberg, H.; Myers, K. J.

    1995-01-01

    The Division of Emergency Medicine at the University of Florida coordinates a unique program with the NASA John F. Kennedy Space Center (KSC) to provide emergency medical support (EMS) for the United States Space Transportation System. This report outlines the organization of the KSC EMS system, training received by physicians providing medical support, logistic and operational aspects of the mission, and experiences of team members. The participation of emergency physicians in support of manned space flight represents another way that emergency physicians provide leadership in prehospital care and disaster management.

  20. Space shuttle operations at the NASA Kennedy Space Center: the role of emergency medicine

    NASA Technical Reports Server (NTRS)

    Rodenberg, H.; Myers, K. J.

    1995-01-01

    The Division of Emergency Medicine at the University of Florida coordinates a unique program with the NASA John F. Kennedy Space Center (KSC) to provide emergency medical support (EMS) for the United States Space Transportation System. This report outlines the organization of the KSC EMS system, training received by physicians providing medical support, logistic and operational aspects of the mission, and experiences of team members. The participation of emergency physicians in support of manned space flight represents another way that emergency physicians provide leadership in prehospital care and disaster management.

  1. Space shuttle operations at the NASA Kennedy Space Center: the role of emergency medicine.

    PubMed

    Rodenberg, H; Myers, K J

    1995-01-01

    The Division of Emergency Medicine at the University of Florida coordinates a unique program with the NASA John F. Kennedy Space Center (KSC) to provide emergency medical support (EMS) for the United States Space Transportation System. This report outlines the organization of the KSC EMS system, training received by physicians providing medical support, logistic and operational aspects of the mission, and experiences of team members. The participation of emergency physicians in support of manned space flight represents another way that emergency physicians provide leadership in prehospital care and disaster management.

  2. [Diagnostic investigation in emergency medicine: Why case history is crucial].

    PubMed

    Mirus, M; Heller, A R</