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Sample records for emergency medicine public

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. [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.

  8. 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

  9. [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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. International emergency medicine fellowships.

    PubMed

    Anderson, Philip D; Aschkenasy, Miriam; Lis, Julian

    2005-02-01

    The active interchange of intellectual ideas in the quest to improve healthcare globally will likely be best served by active interchange among physicians around the world. Subspecialty fellowship training programs for United States and foreign graduates will provide a focused path to development of a global network of physicians dedicated to the delivery of high-quality emergency health services.

  16. 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

  17. 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.

  18. 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.

  19. [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.

  20. [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.

  1. 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.

  2. 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

  3. [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.

  4. 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.

  5. 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

  6. 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.

  7. [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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Index of International Publications in Aerospace Medicine

    DTIC Science & Technology

    2010-10-01

    International Publications in Aerospace Medicine Edmonds C, McKenzie B. Diving Medicine for Scuba Divers. Carnegie, Victoria, Australia: J. L...to Coping with Injury and Illness. San Pedro, CA, USA: Best Publishing Co., 1985. Nessirio BA. Rozhdenie Metoda “Nasyshchennykh Pogruzhenii... Metoda Dlitel’nogo Prebyvaniia Cheloveka pod Povyshennym Davleniem. Sankt-Peterburg, Russia: Kosta, 2004. Parker J. The Sports Diving Medical: A Guide to

  8. 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.

  9. [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.

  10. 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.

  11. 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.

  12. 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

  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. 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.

  15. 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.

  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. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  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. [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.

  4. 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'.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. [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.

  12. 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.

  13. 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.

  14. [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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. Index of International Publications in Aerospace Medicine

    DTIC Science & Technology

    2007-01-01

    C, Lowry C, Pennefather J. Diving and Subaquatic Medicine. California, USA: Best Publishing Co., 1981. Edmonds C, McKenzie B. Diving Medicine for...Practical Guide to Coping with Injury and Illness. San Pedro, CA, USA: Best Publishing Co., 1985. Nessirio BA. Rozhdenie Metoda “Nasyshchennykh...Pogruzhenii” – Metoda Dlitel’nogo Prebyvaniia Cheloveka pod Povyshennym Davleniem. Sankt-Peterburg, Russia: Kosta, 2004. Parker J. The Sports Diving

  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.

  13. 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.

  14. 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.

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

    PubMed

    Holčík, Jan

    2016-01-01

    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.

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  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. 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

  7. 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.

  8. 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.

  9. 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

  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. [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".

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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.].

  17. 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.

  18. 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.

  19. 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

  20. 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...

  1. 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...

  2. 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...

  3. 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…

  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. 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.

  6. [An overview in genomic medicine and public health].

    PubMed

    Burguete, Ana; Bermúdez-Morales, Víctor H; Madrid-Marina, Vicente

    2009-01-01

    Genomics, as a scientific discipline responsible for genome maps, sequencing and functional analysis of genomes, allows for continually expanding knowledge of the structure and function of genomes. The influence of genomics on medicine generates a new perspective for how we perceive health and disease, knowing the influence of genetic variations on susceptibility to disease. In the area of public health, genetic epidemiology translates genetic knowledge into individual and public actions, evaluating the effect of the distribution of genetic determinants and their interaction with environmental factors involved in the etiology of human diseases. In addition, genomic medicine suggests new diagnostic systems, genetic associations and nutritional disorders, specific responses to diverse drugs, and the design of new drugs for susceptible groups. And yet, the greatest advances in genomic medicine in the field of health are forthcoming.

  7. 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

  8. 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.

  9. 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).

  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. 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

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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...

  2. 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...

  3. 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".

  4. 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.

  5. 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

  6. 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.

  7. 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…

  8. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for Healthcare Research and... relinquishment from Emergency Medicine Patient Safety Foundation of its status as a Patient Safety...

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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.

  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. 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.

  18. 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.

  19. 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

  20. 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"…

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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…

  13. 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.

  14. 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.

  15. 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,...

  16. ['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.

  17. 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

  18. 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.

  19. 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…

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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).

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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".

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  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. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Zika virus and the never-ending story of emerging pathogens and transfusion medicine.

    PubMed

    Marano, Giuseppe; Pupella, Simonetta; Vaglio, Stefania; Liumbruno, Giancarlo M; Grazzini, Giuliano

    2016-03-01

    In the last few years, the transfusion medicine community has been paying special attention to emerging vector-borne diseases transmitted by arboviruses. Zika virus is the latest of these pathogens and is responsible for major outbreaks in Africa, Asia and, more recently, in previously infection-naïve territories of the Pacific area. Many issues regarding this emerging pathogen remain unclear and require further investigation. National health authorities have adopted different prevention strategies. The aim of this review article is to discuss the currently available, though limited, information and the potential impact of this virus on transfusion medicine.

  10. Essentials of Pediatric Emergency Medicine Fellowship Part 7: Careers in PEM.

    PubMed

    Allen, Coburn H; Anders, Jennifer; Ishimine, Paul; Roskind, Cindy; Shook, Joan

    2016-11-01

    This article is the last 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 on program completion. This article focuses on the many career paths as educators, researchers, advocates, innovators, consultants, administrators, and leaders available to pediatric emergency medicine physicians, in both clinical and nonclinical realms, and how fellows and junior faculty can enrich and prolong their careers through diversification.

  11. Cost-effectiveness analysis appraisal and application: an emergency medicine perspective.

    PubMed

    April, Michael D; Murray, Brian P

    2017-03-10

    Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously-published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely-cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the United States Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of non-cost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic

  12. [Diagnostic investigation in emergency medicine: Why case history is crucial].

    PubMed

    Mirus, M; Heller, A R

    2017-04-01

    We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact.

  13. The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

    PubMed

    Pines, Jesse M

    2006-05-01

    Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

  14. From cradle to adolescence: the development of Research in European Pediatric Emergency Medicine.

    PubMed

    Mintegi, Santiago; Lyttle, Mark D; Maconochie, Ian K; Benito, Javier; Gervaix, Alain; Moll, Henriette; Shavit, Itai; Da Dalt, Liviana; Waisman, Yehezkel

    2014-02-01

    Pediatric emergency medicine (PEM) has been developing rapidly but heterogeneously in many European countries in recent years, and many national PEM societies have been founded to improve the quality of care of ill and injured children and adolescents. Key facets of any such improvement are the development, delivery and translation of high-quality research. Research in European Pediatric Emergency Medicine (REPEM) has developed a robust international structure involving clinicians, academics and national PEM research networks. This structure facilitates research collaboration within Europe and with PEM research networks from other continents. Multicentre research carried out in this way will bring about improvements in the quality of emergency care for children in European emergency departments, and result in a better quality of life for children and adolescents. This paper outlines the background and achievements of REPEM to date and describes the current structure and next steps.

  15. Exploring situational awareness in emergency medicine: developing a shared mental model to enhance training and assessment.

    PubMed

    Lowe, David J; Ireland, Alastair J; Ross, Al; Ker, Jean

    2016-04-29

    Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medicine. Situational awareness (SA), one key component of NTS, is a key skill for emergency physicians (EPs) during initial training and throughout their career. Furthermore, the majority of frameworks used to evaluate clinical performance incorporate SA as one key component. This review seeks to define and explore the concept of SA within the context of emergency medicine. We describe SA at an individual, team and departmental level. Development of this ability enables EPs to function effectively within the challenging environment of the emergency department (ED). Enhancing our understanding of SA may develop the cognitive process that underpins our clinical performance. We propose a model for consideration to support evaluation and training of SA within the ED, linking the model to the novice expert continuum.

  16. Emerging Roles for MicroRNAs in Perioperative Medicine

    PubMed Central

    Neudecker, Viola; Brodsky, Kelley S.; Kreth, Simone; Ginde, Adit A.; Eltzschig, Holger K.

    2016-01-01

    MicroRNAs (miRNAs) are small, non-protein-coding, single-stranded RNAs. They function as posttranscriptional regulators of gene expression by interacting with target mRNAs. This process prevents translation of target mRNAs into a functional protein. miRNAs are considered to be functionally involved in virtually all physiologic processes, including differentiation and proliferation, metabolism, hemostasis, apoptosis, and inflammation. Many of these functions have important implications for anesthesiology and critical care medicine. Studies indicate that miRNA expression levels can be used to predict the risk for eminent organ injury or sepsis. Pharmacologic approaches targeting miRNAs for the treatment of human diseases are currently being tested in clinical trials. The present review highlights the important biological functions of miRNAs and their usefulness as perioperative biomarkers and discusses the pharmacologic approaches that modulate miRNA functions for disease treatment. In addition, the authors discuss the pharmacologic interactions of miRNAs with currently used anesthetics and their potential to impact anesthetic toxicity and side effects. PMID:26632665

  17. The emergence of "lifestyle medicine" as a structured approach for management of chronic disease.

    PubMed

    Egger, Garry J; Binns, Andrew F; Rossner, Stephan R

    2009-02-02

    Chronic diseases with a lifestyle-based aetiology currently make up a significant proportion of primary care consultations, but management often falls between the demands of public and clinical health. A modified clinical approach, based around the concept of "lifestyle medicine", helps fill the gap by adding behavioural, motivational and environmental skills to conventional medical practice. When used in a multidisciplinary setting, lifestyle medicine offers potential cost and effectiveness benefits, which are beginning to be realised.

  18. Education scholarship in emergency medicine part 1: innovating and improving teaching and learning.

    PubMed

    Sherbino, Jonathan; Van Melle, Elaine; Bandiera, Glen; McEwen, Jill; Leblanc, Constance; Bhanji, Farhan; Frank, Jason R; Regehr, Glenn; Snell, Linda

    2014-05-01

    As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Canadian Association for Medical Education's definition, education scholarship (including both research and innovation) is defined. A rationale for why education scholarship should be a priority for EM is discussed.

  19. Off-label prescription of genetically modified organism medicines in europe: emerging conflicts of interest?

    PubMed

    Schagen, Frederik H E; Hoeben, Rob C; Hospers, Geke A P

    2014-10-01

    Recently, the first human medicine containing a genetically modified organism (GMO medicine) was authorized for use in the European market. Just as any medicinal product, the market authorization for a GMO medicine contains a precise description of the therapeutic use for which the medicinal product is intended. Within this use, the application of the GMO medicine is permitted, without the need for the institution to obtain a specific permit. In practice, however, medicinal products are also frequently prescribed for treatment outside the registered therapeutic use, a practice that is referred to as "off-label use." While off-label use of conventional medicines is permitted and has been very useful, the off-label use of GMO medicines is not covered in the European Union (EU) legislation or guidelines and falls under each member state's national environmental legislation. This implies that in the Netherlands and most other EU member states, an environmental permit will be required for any institution that uses the GMO medicine outside the registered application(s). In the Netherlands, this permit is identical to the permits required for the execution of clinical trials involving nonregistered GMOs. The application procedure for such permit is time-consuming. This process can therefore limit the therapeutic options for medical professionals. As a consequence, desired treatment regimens could be withheld for certain patient (groups). To make future off-label use of GMO medicines permissible in a way that is acceptable for all stakeholders, regulators should adopt a proactive attitude and formulate transparent legislative procedures for this. Only then the field can maintain the public acceptance of GMO medicines, while maintaining the freedom to operate of medical professionals.

  20. Pulmonary Hypertension and Right Ventricular Failure in Emergency Medicine.

    PubMed

    Wilcox, Susan R; Kabrhel, Christopher; Channick, Richard N

    2015-12-01

    Pulmonary hypertension is a hemodynamic condition, defined as a mean pulmonary artery pressure by right-sided heart catheterization of at least 25 mm Hg at rest. It is classified into 5 general groups based on the underlying cause, with left ventricular failure and chronic obstructive pulmonary disease being 2 of the most common causes in the United States. Although the specifics of the pathophysiology will vary with the cause, appreciating the risks of pulmonary hypertension and right ventricular failure is critical to appropriately evaluating and resuscitating pulmonary hypertension patients in the emergency department (ED). Patients may present to the ED with complaints related to pulmonary hypertension or unrelated ones, but this condition will affect all aspects of care. Exertional dyspnea is the most common symptom attributable to pulmonary hypertension, but the latter should be considered in any ED patient with unexplained dyspnea on exertion, syncope, or signs of right ventricular dysfunction. Patients with right ventricular failure are often volume overloaded, and careful volume management is imperative, especially in the setting of hypotension. Vasopressors and inotropes, rather than fluid boluses, are often required in shock to augment cardiac output and reduce the risk of exacerbating right ventricular ischemia. Intubation should be avoided if possible, although hypoxemia and hypercapnia may also worsen right-sided heart function. Emergency physicians should appreciate the role of pulmonary vasodilators in the treatment of pulmonary arterial hypertension and recognize that patients receiving these medications may rapidly develop right ventricular failure and even death without these therapies. Patients may require interventions not readily available in the ED, such as a pulmonary artery catheter, inhaled pulmonary vasodilators, and mechanical support with a right ventricular assist device or extracorporeal membrane oxygenation. Therefore, early

  1. Commentary: public health and preventive medicine: proposing a transformed context for medical education and medical care.

    PubMed

    Levy, Barry S; Wegman, David H

    2012-07-01

    Because medical students and residents receive inadequate education and training in public health and preventive medicine, they will miss many opportunities, as they practice medicine, to improve the health of individual patients and populations. Although there is an ongoing need to expand the number and improve the specialist training of public health and preventive medicine residents, all medical students and residents should enter practice with substantive knowledge and practical skills in public health and preventive medicine. This knowledge and these skills will make them more effective in such areas as enabling patients to make lifestyle changes, identifying and reducing occupational and environmental risk factors, and empowering patients to manage their chronic health conditions. The authors propose a paradigm shift to establish public health and preventive medicine as the context for medical education and medical care.

  2. Using Computer Technology in the Automation of Clinical and Operating Systems in Emergency Medicine

    PubMed Central

    Guarisco, Joseph S.

    2001-01-01

    The practical application of Emergency Medicine throughout the country has historically been viewed by healthcare workers and patients as one of inefficiency and chaos. Believing that the practice of Emergency Medicine was, to the contrary, predictable, we at Ochsner felt that tremendous improvements in efficiency could be won if the vast amount of data generated in our experience of nearly 40,000 Emergency Department visits per year could be harvested. Such improvements would require the employment of computer technology and powerful database management systems. By applying these tools to profile the practice of Emergency Medicine in our institution, we were able to harvest important clinical and operational information that was ultimately used to improve department efficiency and productivity. The ability to analyze data and manage processes within the Emergency Department allowed us to target resources much more efficiently, significantly reducing nonproductive work. The collected data were sorted and filtered by a host of variables creating the ability to profile subsets of our practice—most importantly, physician practice habits and performance. Furthermore, the development of “patient tracking” software allowed us to update, view, and trend data in real-time and tweak clinical and operational processes simultaneously. The data-driven, analytical approach to the management of the Emergency Department has yielded significant improvements in service to our patients and lower operational costs. PMID:21765721

  3. How to get on a SpR rotation in emergency medicine (and make the most of it)

    PubMed Central

    Lloyd, G; O'Sullivan, I; Rawlinson, N; Mann, C; Harris, A

    2003-01-01

    Emergency medicine is now proving a popular specialty in the United Kingdom. A recent report ranks emergency medicine second in specialties attracting the most applications for specialist registrar (SpR) interview. Numbered posts are becoming increasingly competitive as a result. This paper offers advice to aspiring emergency department SpRs. It identifies areas in which a curriculum vitae may be improved. It should also enable emergency department trainees to set objectives for their early SpR years. PMID:12748138

  4. A top-five list for emergency medicine: a pilot project to improve the value of emergency care.

    PubMed

    Schuur, Jeremiah D; Carney, Dylan P; Lyn, Everett T; Raja, Ali S; Michael, John A; Ross, Nicholas G; Venkatesh, Arjun K

    2014-04-01

    IMPORTANCE The mean cost of medical care in the United States is growing at an unsustainable rate; from 2003 through 2011, the cost for an emergency department (ED) visit rose 240%, from $560 to $1354. The diagnostic tests, treatments, and hospitalizations that emergency clinicians order result in significant costs. OBJECTIVE To create a "top-five" list of tests, treatments, and disposition decisions that are of little value, are amenable to standardization, and are actionable by emergency medicine clinicians. DESIGN, SETTING, AND PARTICIPANTS Modified Delphi consensus process and survey of 283 emergency medicine clinicians (physicians, physician assistants, and nurse practitioners) from 6 EDs. INTERVENTION We assembled a technical expert panel (TEP) and conducted a modified Delphi process to identify a top-five list using a 4-step process. In phase 1, we generated a list of low-value clinical decisions from TEP brainstorming and e-mail solicitation of clinicians. In phase 2, the TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. In phase 3, we surveyed all ordering clinicians from the 6 EDs regarding distinct aspects of each item. In phase 4, the TEP voted for a final top-five list based on survey results and discussion. MAIN OUTCOMES AND MEASURES A top-five list for emergency medicine. The TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. The survey asked clinicians to score items on the potential benefit or harm to patients and the provider actionability of each item. Voting and surveys used 5-point Likert scales. A Pearson interdomain correlation was used. RESULTS Phase 1 identified 64 low-value items. Phase 2 narrowed this list to 7 laboratory tests, 3 medications, 4 imaging studies, and 3 disposition decisions included in the phase 3 survey (71.0% response rate). All 17 items showed a significant positive correlation between benefit and actionability (r, 0.19-0.37 [P

  5. Evaluation of Social Media Use by Emergency Medicine Residents and Faculty

    PubMed Central

    Pearson, David; Bond, Michael C.; Kegg, Jason; Pillow, Tyson; Hopson, Laura; Cooney, Robert; Garg, Manish; Khadpe, Jay; Runyon, Michael; Patterson, Leigh

    2015-01-01

    Introduction Clinicians and residency programs are increasing their use of social media (SM) websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM) residents and faculty. Methods In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD) listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher’s exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK) was used for all analyses. Results We received 1,314 responses: 63% of respondents were male, 40% were <30 years of age, 39% were between the ages 31 and 40, and 21% were older than 40. The study group consisted of 772 residents and 542 faculty members (15% were program directors, 21% were assistant or associate PDs, 45% were core faculty, and 19% held other faculty positions. Forty-four percent of respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [p<0.0001]), entertainment (61% vs 47% [p<0.0001]), and videos (42% vs 23% [p=0.0006]). Residents used Facebook™ and YouTube™ more often than faculty (86% vs 67% [p<0.001]; 53% vs 46% [p=0.01]), whereas residents used Twitter™ (19% vs 26% [p=0.005]) and LinkedIn™ (15% vs 32% [p<0.0001]) less than faculty. Overall, residents used SM sites more than faculty, notably in daily use (30% vs 24% [p<0.001]). For professional use, residents were most interested in its use for open positions/hiring (30% vs 18% [p<0.0001]) and videos (33% vs 26% [p=0.005]) and less interested than faculty with award postings (22% vs 33% [p<0.0001]) or publications (30% vs 38% [p

  6. Critical Emergency Medicine Procedural Skills: A Comparative Study of Methods for Teaching and Assessment.

    ERIC Educational Resources Information Center

    Chapman, Dane M.; And Others

    Three critical procedural skills in emergency medicine were evaluated using three assessment modalities--written, computer, and animal model. The effects of computer practice and previous procedure experience on skill competence were also examined in an experimental sequential assessment design. Subjects were six medical students, six residents,…

  7. Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

    PubMed

    Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

    2015-05-01

    In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame.

  8. Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine.

    PubMed

    Véliz-Martínez, Pedro L; Jorna-Calixto, Ana R; Oramas-González, René

    2016-10-01

    INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVE Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists' competence and performance. KEYWORDS Clinical competency, competency-based education, professional education, intensive care, emergency medicine, urgent care, continuing medical education, curriculum, medical residency, Cuba.

  9. Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada

    PubMed Central

    Morgan, Steven G.; Li, Winny; Yau, Brandon; Persaud, Nav

    2017-01-01

    BACKGROUND: Canada’s universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. METHODS: We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. RESULTS: The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). INTERPRETATION: Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians’ pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. PMID:28246223

  10. A qualitative study exploring medicines use pattern and practice among general public in Malaysia

    PubMed Central

    2016-01-01

    Objective: The objective of this study is to explore the pattern and practice of medicine use among the general public; and to explore the key factors influencing medicine use among medicine users. Methods: A qualitative approach using focus group discussions was conducted to get in-depth information about medicines use pattern and practice from the general public. Adult people who reported using medicines at the time of study or in the previous month were approached. Two focus group discussions were audio-recorded and transcribed verbatim. The obtained data were analysed using thematic content analysis. Results: This study found that there are some misunderstanding about the appropriate use of medicines. The majority of the participants reported that they were complying with their medication regimen. However, forgetting to take medicines was stated by 4 participants while 2 participants stopped taking medicines when they felt better. In addition, 10 participants reporting using medicines according to their own knowledge and past experience. Whereas 4 participants took medicines according to other informal resources such as family, friends or the media. Seven participants have experienced side effects with using medicines, 4 of them informed their doctor while 3 participants stopped taking medicines without informing their doctor. Conclusion: There was a misunderstanding about medicines use in terms of medication compliance, self-management of the illness and the resources of information about using medicines. Many efforts are still needed from health care professionals to provide sufficient information about medicines use in order to decrease the risk of inappropriate use of medicines and to achieve better therapeutic outcome. PMID:27382428

  11. Preparedness and emergency response research centers: using a public health systems approach to improve all-hazards preparedness and response.

    PubMed

    Leinhos, Mary; Qari, Shoukat H; Williams-Johnson, Mildred

    2014-01-01

    In 2008, at the request of the Centers for Disease Control and Prevention (CDC), the Institute of Medicine (IOM) prepared a report identifying knowledge gaps in public health systems preparedness and emergency response and recommending near-term priority research areas. In accordance with the Pandemic and All-Hazards Preparedness Act mandating new public health systems research for preparedness and emergency response, CDC provided competitive awards establishing nine Preparedness and Emergency Response Research Centers (PERRCs) in accredited U.S. schools of public health. The PERRCs conducted research in four IOM-recommended priority areas: (1) enhancing the usefulness of public health preparedness and response (PHPR) training, (2) creating and maintaining sustainable preparedness and response systems, (3) improving PHPR communications, and (4) identifying evaluation criteria and metrics to improve PHPR for all hazards. The PERRCs worked closely with state and local public health, community partners, and advisory committees to produce practice-relevant research findings. PERRC research has generated more than 130 peer-reviewed publications and nearly 80 practice and policy tools and recommendations with the potential to significantly enhance our nation's PHPR to all hazards and that highlight the need for further improvements in public health systems.

  12. Emerging arboviruses and public health challenges in Brazil

    PubMed Central

    Lima-Camara, Tamara Nunes

    2016-01-01

    ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. PMID:27355468

  13. Energy drinks: an emerging public health hazard for youth.

    PubMed

    Pomeranz, Jennifer L; Munsell, Christina R; Harris, Jennifer L

    2013-05-01

    Energy drinks are emerging as a public health threat and are increasingly consumed by youth internationally. Energy drinks contain high levels of caffeine, sugar, and novel ingredients, and are often marketed through youth-oriented media and venues. We review these practices and the current inconsistent state of labeling. We also examine international support for regulation of these products, including a survey showing that 85 per cent of United States parents agreed that regulations requiring caffeine content disclosure and warning labels on energy drinks are warranted. We then examine the regulatory structure for energy drinks in the United States, analyzing legal and self-regulatory strategies to protect consumers, especially youth, from these potentially dangerous products. Recommended government interventions include revised labeling requirements, addressing problematic ingredients, and enacting retail restrictions. We conclude by identifying areas for future research.

  14. Electronic media, violence, and adolescents: an emerging public health problem.

    PubMed

    David-Ferdon, Corinne; Hertz, Marci Feldman

    2007-12-01

    Adolescents' access to and use of new media technology (e.g., cell phone, personal data assistant, computer for Internet access) are on the rise, and this explosion of technology brings with it potential benefits and risks. Attention is growing about the risk of adolescents to become victims of aggression perpetrated by peers with new technology. In September 2006, the Centers for Disease Control and Prevention convened a panel of experts in technology and youth aggression to examine this specific risk. This special issue of the Journal of Adolescent Health presents the data and recommendations for future directions discussed at the meeting. The articles in the Journal support the argument that electronic aggression is an emerging public health problem in need of additional prevalence and etiological research to support the development and evaluation of effective prevention programs.

  15. Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

    PubMed

    Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

    2014-12-01

    Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

  16. 33 CFR 263.25 - Authority for emergency streambank and shoreline protection of public works and nonprofit public...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... streambank and shoreline protection of public works and nonprofit public services (Section 14). 263.25... and shoreline protection of public works and nonprofit public services (Section 14). (a) Legislative... year, for the construction, repair, restoration, and modification of emergency streambank and...

  17. 76 FR 37826 - Public Land Order No. 7773; Emergency Withdrawal of Public and National Forest System Lands...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ...,776 acres of public and National Forest System lands from location and entry under the 1872 Mining Law... alter the applicability of the public land laws other than the 1872 Mining Law (30 U.S.C. 22 et seq.). 3... Bureau of Land Management Public Land Order No. 7773; Emergency Withdrawal of Public and National...

  18. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  19. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  20. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  1. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  2. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  3. Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

    PubMed

    Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors.

  4. 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.

  5. Incommensurable worldviews? Is public use of complementary and alternative medicines incompatible with support for science and conventional medicine?

    PubMed

    Stoneman, Paul; Sturgis, Patrick; Allum, Nick; Sibley, Elissa

    2013-01-01

    Proponents of controversial Complementary and Alternative Medicines, such as homeopathy, argue that these treatments can be used with great effect in addition to, and sometimes instead of, 'conventional' medicine. In doing so, they accept the idea that the scientific approach to the evaluation of treatment does not undermine use of and support for some of the more controversial CAM treatments. For those adhering to the scientific canon, however, such efficacy claims lack the requisite evidential basis from randomised controlled trials. It is not clear, however, whether such opposition characterises the views of the general public. In this paper we use data from the 2009 Wellcome Monitor survey to investigate public use of and beliefs about the efficacy of a prominent and controversial CAM within the United Kingdom, homeopathy. We proceed by using Latent Class Analysis to assess whether it is possible to identify a sub-group of the population who are at ease in combining support for science and conventional medicine with use of CAM treatments, and belief in the efficacy of homeopathy. Our results suggest that over 40% of the British public maintain positive evaluations of both homeopathy and conventional medicine simultaneously. Explanatory analyses reveal that simultaneous support for a controversial CAM treatment and conventional medicine is, in part, explained by a lack of scientific knowledge as well as concerns about the regulation of medical research.

  6. Changing my perspective: How the development of emergency medicine in Sri Lanka can inform the Australasian experience.

    PubMed

    Taylor, Nicholas

    2016-10-01

    When compared to an Australasian ED, the two major differences in the emergency medicine practice at Teaching Hospital Karapitiya are which patients are selected at triage and how those selected present. These differences have caused me to reflect on emergency medicine practice in Australasia and wonder if this practice is sustainable.

  7. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    ORAU's Oak Ridge Institute for Science Education

    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. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  8. Rural GPs’ attitudes toward participating in emergency medicine: a qualitative study

    PubMed Central

    Hjortdahl, Magnus; Halvorsen, Peder; Risør, Mette Bech

    2016-01-01

    Objective 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. Design Thematic analysis of focus group interviews. Setting Four rural casualty clinics in Norway. Participants GPs with experience ranging from one to 32 years. Results 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. Conclusion 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 POINTSThe 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

  9. Towards medicines regulatory authorities' quality performance improvement: value for public health.

    PubMed

    Pejović, Gordana; Filipović, Jovan; Tasić, Ljiljana; Marinković, Valentina

    2016-01-01

    The purpose of this article is to explore the possibility of implementing total quality management (TQM) principles in national medicines regulatory authorities in Europe to achieve all public health objectives. Bearing in mind that medicines regulation is a governmental function that serves societal objectives to protect and promote public health, measuring the effective achievement of quality objectives related to public health is of utmost importance. A generic TQM model for meeting public health objectives was developed and was tested on 10 European national medicines regulatory authorities with different regulatory performances. Participating national medicines regulatory authorities recognised all TQM factors of the proposed model in implemented systems with different degrees of understanding. An analysis of responses was performed within the framework of two established criteria-the regulatory authority's category and size. The value of the paper is twofold. First, the new generic TQM model proposes to integrate four public health objectives with six TQM factors. Second, national medicines regulatory authorities were analysed as public organisations and health authorities to develop a proper tool for assessing their regulatory performance. The paper emphasises the importance of designing an adequate approach to performance measurement of quality management systems in medicines regulatory authorities that will support their public service missions.

  10. Review article: Clinical impact of non-cardiologist-performed transthoracic echocardiography in emergency medicine, intensive care medicine and anaesthesia.

    PubMed

    Haji, Darsim L; Royse, Alistair; Royse, Colin F

    2013-02-01

    There is increased realisation of the emerging role of point-of-care transthoracic echocardiography (TTE) as 'ultrasound-assisted examination', given the low sensitivity of clinical examination for cardiovascular pathologies and the time-critical nature of these pathologies. There is evidence that point-of-care TTE provides higher accuracy in patient assessment and management, with potential prognostic impact by assessing the severity of cardiac dysfunction and response to treatment. Point-of-care TTE is increasingly used by non-cardiologists, as a diagnostic, screening or monitoring tool. The literature shows that TTE identifies new clinical findings, and conversely can accurately rule out clinically important pathologies. Recent reports have examined more advanced ultrasound devices and patients in the critical care settings of emergency medicine, intensive care and anaesthesia. The diagnostic capability of new portable devices is improving rapidly and outdating its predecessors, thereby improving confidence in echocardiography findings.

  11. The Geneva Conferences and the emergence of the International Network for Person-centered Medicine.

    PubMed

    Mezzich, Juan E

    2011-04-01

    The yearly Geneva Conferences on Person-centered Medicine started in May 2008 as a collaborative effort of global medical and health organizations and committed clinicians and scholars to place the whole person at the centre of medicine and health care. They were informed by the traditions of great ancient civilizations and recent developments in clinical care and public health. The process of the Geneva Conferences led to the development of the International Network for Person-centered Medicine as a non-for-profit institution aimed at organizing future editions of the Geneva Conference and building person-centred medicine as a paradigmatic repriorizing of the medical and health fields in collaboration inter alia with the World Medical Association, the World Health Organization and the World Organization of Family Doctors.

  12. Driving forces behind the past and future emergence of personalized medicine.

    PubMed

    Steffen, Julius Alexander; Steffen, Jan Simon

    2013-01-17

    Personalized medicine can be seen as a continuously developing approach to tailoring treatments according to the individual characteristics of a patient. In some way, medicine has always been personalized. During the last decade, however, scientific and technological progress have made truly personalized healthcare increasingly become reality. Today's personalized medicine involves targeted therapies and diagnostic tests. The development of targeted agents represents a major investment opportunity to pharmaceutical companies, which have been facing the need to diversify their business due to an increasingly challenging market place. By investing into the development of personalized therapies, pharmaceutical companies mitigate a major part of the risks posed by factors such as patent expiries or generic competition. Viewing upon personalized medicine from different perspectives points out the multi-causality of its emergence. Research efforts and business diversification have been two main driving forces; they do supplement each other, however, are not jointly exhaustive in explaining the emergence of this approach. Especially in the future, a number of further stakeholders will impact the evolution of personalized medicine.

  13. [The role of the German public health service in social medicine].

    PubMed

    Leidel, J

    2005-10-01

    Although the German public health service is mainly concerned with social medical tasks there is too little awareness of the fact that social medicine forms the scientific basis of most actions. As a matter of fact social medicine in public health departments is often reduced to mere medical insurance and expert reports. This is mainly due to the historical development of social medicine in Germany. Among the numerous important social medical tasks of the public health service, this article mainly concentrates on local coordination, health promotion, health care, and social compensation, including subsidiary medical care of certain groups of the population and aspects of infectious disease control with particular attention to measures against AIDS. The further development of both the public health service and social medicine requires a closer cooperation between them.

  14. Should a reformed system be prepared for public health emergencies, and what does that mean anyway?

    PubMed

    Katz, Rebecca; Levi, Jeffrey

    2008-01-01

    Any reformed health care system must be able to react to and mitigate the consequences of a public health emergency. This article identifies four essential components of public health emergency preparedness, and presents measures that can be taken immediately to improve our capacity to respond to emergencies.

  15. Investigation on Legal Problems Encountered by Emergency Medicine Physicians in Turkey

    PubMed Central

    Kayipmaz, Afsin Emre; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem

    2015-01-01

    Background Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians’ legal-administrative problems and reveal their level of understanding on forensic cases. Methods An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant. Results 294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments. Conclusion We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians’ level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post

  16. The power of collaboration: integrating a preventive medicine-public health curriculum into a pediatric residency.

    PubMed

    Varkey, Prathibha; Billings, Marcie L; Matthews, Gretchen A; Voigt, Robert G

    2011-10-01

    This is one of six short papers that describe additional innovations to help integrate public health into medical education; these were featured in the "Patients and Populations: Public Health in Medical Education" conference. They represent relatively new endeavors or curricular components that had not been explored in prior publications. Although evaluation data are lacking, it was considered to be of value to medical educators to share a brief description of the collaboration between the Division of Preventive, Occupational, and Aerospace Medicine and the Department of Pediatrics at Mayo Clinic to integrate a preventive medicine-public health curriculum into the pediatric residency.

  17. Hantaviruses: an emerging public health threat in India? A review.

    PubMed

    Chandy, S; Abraham, S; Sridharan, G

    2008-11-01

    The emerging viral diseases haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS) are a cause of global concern as they are increasingly reported from newer regions of the world. The hantavirus species causing HFRS include Hantaan virus,Seoul virus, Puumala virus, and Dobrava-Belgrade virus while Sin Nombre virus was responsible for the 1993 outbreak of HCPS in the Four Corners Region of the US. Humans are accidental hosts and get infected by aerosols generated from contaminated urine,feces and saliva of infected rodents. Rodents are the natural hosts of these viruses and develop persistent infection. Human to human infections are rare and the evolution of the virus depends largely on that of the rodent host. The first hantavirus isolate to be cultured, Thottapalayam virus,is the only indigenous isolate from India,isolated from an insectivore in 1964 in Vellore, South India. Research on hantaviruses in India has been slow but steady since 2005. Serological investigation of patients with pyrexic illness revealed presence of anti-hantavirus IgM antibodies in 14.7% of them. The seropositivity of hantavirus infections in the general population is about 4% and people who live and work in close proximity with rodents have a greater risk of acquiring hantavirus infections. Molecular and serological evidence of hantavirus infections in rodents and man has also been documented in this country. The present review on hantaviruses is to increase awareness of these emerging pathogens and the threats they pose to the public health system.

  18. Public-private collaborations and partnerships in stratified medicine: making sense of new interactions.

    PubMed

    Chataway, Joanna; Fry, Caroline; Marjanovic, Sonja; Yaqub, Ohid

    2012-09-15

    The field of personalised or stratified medicine is evolving alongside the formation of a plethora of public/private partnerships and collaborations. These new institutional forms, or 'social technologies', are varied and emerge in response to several drivers, including the need to draw on a broader base of data inputs relating to genomics, patient behaviour and healthcare system differentiation. This paper discusses some of these drivers of partnerships and collaborations. Although the number of such partnerships is growing, their rationale and basis for collaboration remains unclear. Public-private collaborations are at the core of the set of new life sciences policies in the UK but there is little indication in the policy documents of clear boundaries for these partnerships. In part, this is due to the lack of empirical evidence at the system level for conceptualising what is still a relatively new approach. The collection of evidence in the form of broad evaluations, rather than tightly focused theoretical studies, is more likely to be related back to systems and be of more use for formulating policy rationales.

  19. Weaving public health education into the fabric of a family medicine residency.

    PubMed

    Potts, Stacy E; Deligiannidis, Konstantinos E; Cashman, Suzanne B; Caggiano, Marie E; Carter, Lisa H; Haley, Heather-Lyn; Ferguson, Warren J

    2011-10-01

    Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice. This public health curriculum was designed to integrate new topics within the current residency structure through longitudinal and concentrated experiences. This strategy has substantially improved public health and prevention education without substantial impact on the already strained residency curricular structure. This paper describes the integration of public health and prevention education into a family medicine residency to help residents acquire the fundamental skills necessary to improve a population's health.

  20. 77 FR 74024 - Notice of Proposed Information Collection for Public Comment; Emergency Solutions Grant Data...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-12

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection for Public Comment; Emergency Solutions...: Emergency Solutions Grants Program Record Keeping Requirements. Description of the need for the information... Solutions Grants (ESG) program recipients will be expected to implement and retain. This submission...

  1. Education scholarship in emergency medicine part 2: supporting and developing scholars.

    PubMed

    Bandiera, Glen; Leblanc, Constance; Regehr, Glenn; Snell, Linda; Frank, Jason R; Sherbino, Jonathan

    2014-05-01

    Emergency medicine (EM) is defined, in part, by clinical excellence across an immense breadth of content and the provision of exemplary bedside teaching to a wide variety of learners. The specialty is also well-suited to a number of emerging areas of education scholarship, particularly in relation to team-based learning, clinical reasoning, acute care response, and simulation-based teaching. The success of EM education scholarship will be predicated on systematic, collective attention to providing the infrastructure for this to occur. Specifically, as a new generation of emergency physicians prepares for education careers, academic organizations need to develop means not only to identify potential scholars but also to mentor, support, and encourage their careers. This paper summarizes the supporting literature and presents related recommendations from a 2013 consensus conference on EM education scholarship led by the Academic Section of the Canadian Association of Emergency Physicians.

  2. Generational Influences in Academic Emergency Medicine: Teaching and Learning, Mentoring, and Technology (Part I)

    PubMed Central

    Mohr, Nicholas M.; Moreno-Walton, Lisa; Mills, Angela M.; Brunett, Patrick H.; Promes, Susan B.

    2010-01-01

    For the first time in history, four generations are working together – Traditionalists, Baby Boomers, Generation Xers, and Millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine (SAEM) Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another. PMID:21314779

  3. 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.

  4. Foundations for a novel emergency medicine subspecialty: sex, gender, and women's health.

    PubMed

    McGregor, Alyson J; Madsen, Tracy E; Clyne, Brian

    2014-12-01

    Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology, presentation, treatment, and outcomes. Sex- and gender-specific medicine (SGM) is a rapidly developing field rooted in women's health; however, inclusion of SGM in emergency medicine (EM) is currently lacking. Incorporating principles of sex, gender, and women's health into emergency care and training curricula is an important first step toward establishing a novel subspecialty. EM is an ideal specialty to cultivate this new field because of its broad interdisciplinary nature, increasing numbers of patient visits, and support from academic medical centers to promote expertise in women's health. This article describes methods used to establish a new multidisciplinary training program in sex, gender, and women's health based in a department of EM. Women's health and SGM program initiatives span clinical care, patient education, clinical research, resident and fellow training, and faculty development.

  5. Generational influences in academic emergency medicine: teaching and learning, mentoring, and technology (part I).

    PubMed

    Mohr, Nicholas M; Moreno-Walton, Lisa; Mills, Angela M; Brunett, Patrick H; Promes, Susan B

    2011-02-01

    For the first time in history, four generations are working together-traditionalists, baby boomers, generation Xers (Gen Xers), and millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. 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 emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another.

  6. Developing a virtual learning course in emergency medicine for F2 doctors.

    PubMed

    Carley, Simon; Mackway-Jones, Kevin

    2007-08-01

    Changes in the regulation of junior doctors' hours and in the design of medical career pathways have rendered the traditional weekly tutorial ineffective for teaching the core knowledge of emergency medicine. In this paper, the inception of a virtual leaning environment and the development of an online course for F2 doctors in our emergency department are described. The course, delivered in the open source Moodle virtual learning environment, allows us to reliably deliver educational content to all our juniors regardless of shift patterns. It provides insight into the effectiveness of that education, and records the students' activities and achievements to a level far beyond that achievable through traditional teaching methods.

  7. Advanced statistics: applying statistical process control techniques to emergency medicine: a primer for providers.

    PubMed

    Callahan, Charles D; Griffen, David L

    2003-08-01

    Emergency medicine faces unique challenges in the effort to improve efficiency and effectiveness. Increased patient volumes, decreased emergency department (ED) supply, and an increased emphasis on the ED as a diagnostic center have contributed to poor customer satisfaction and process failures such as diversion/bypass. Statistical process control (SPC) techniques developed in industry offer an empirically based means to understand our work processes and manage by fact. Emphasizing that meaningful quality improvement can occur only when it is exercised by "front-line" providers, this primer presents robust yet accessible SPC concepts and techniques for use in today's ED.

  8. EM Talk: communication skills training for emergency medicine patients with serious illness.

    PubMed

    Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert

    2016-06-01

    The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice.

  9. Essentials of Pediatric Emergency Medicine Fellowship: Part 3: Clinical Education and Experience.

    PubMed

    Mittiga, Matthew R; Nagler, Joshua; Eldridge, Charles D; Ishimine, Paul; Zuckerbraun, Noel S; McAneney, Constance M

    2016-07-01

    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 clinical aspects of fellowship training including the impact of the clinical environment, modalities for teaching and evaluation, and threats and opportunities in clinical education.

  10. Travel medicine physician adherence to guidelines for the emergency self treatment of malaria.

    PubMed

    Flaherty, Gerard T; Walden, Lucas M; Townend, Michael

    2016-05-01

    Few studies have examined emergency self treatment (EST) antimalarial prescribing patterns. 110 physician-members of the Travel Medicine Society of Ireland and British Global and Travel Health Association participated in this study. There was a trend towards the prescription of EST for travel to remote low-risk malaria areas; for long-term residents living in low-risk areas; and for frequent travellers to low-risk areas. This study provides insights into the use of EST in travellers' malaria.

  11. Role of Feedback during Evaluation in Improving Emergency Medicine Residents’ Skills; an Experimental Study

    PubMed Central

    Vafaei, Ali; Heidari, Kamran; Hosseini, Mohammad-Ali; Alavi-Moghaddam, Mostafa

    2017-01-01

    Introduction: Evaluation of students’ learning in clinical education system is one of the most important and challenging issues that facilities in this field have been facing. The present study aimed to evaluate the role of feedback during evaluation in increasing emergency medicine residents’ clinical skills. Method: The present experimental study was performed on all second year emergency medicine residents of two educational hospitals, Tehran, Iran, with switching replications design and before-after method. They were randomly allocated to two groups (with or without feedback) and evaluated three times regarding chest ultrasonography for trauma patients, using direct observation of procedural skills (DOPS) and valid and reliable checklist. Data were analyzed using SPSS 20. Results: 30 emergency medicine residents with the mean age of 36.63 ± 30.30 years were allocated to two equal groups (56.7% male). Studied groups were similar regarding the baseline characteristics. In both groups, obtained scores showed a significant increase from the first to the third evaluation (p < 0.001). Mean scores of first and second evaluations were 10.24 ± 0.77, 17.73 ± 0.46 in feedback receivers and 9.73 ± 0.77 and 12.13 ± 0.47 in others (p < 0.001). Mean third score after switching groups were 18.53 ± 0.22 in feedback receivers and 18.99 ± 0.22 in others (p = 0.213). Conclusion: Based on the findings of the present study, giving feedback after evaluating the second year emergency medicine residents regarding chest ultrasonography for trauma patients, led to a significant improvement in their scores in future evaluations and consequently their skill. PMID:28286835

  12. Saving lives: a computer simulation game for public education about emergencies

    SciTech Connect

    Morentz, J.W.

    1985-01-01

    One facet of the Information Revolution in which the nation finds itself involves the utilization of computers, video systems, and a variety of telecommunications capabilities by those who must cope with emergency situations. Such technologies possess a significant potential for performing emergency public education and transmitting key information that is essential for survival. An ''Emergency Public Information Competitive Challenge Grant,'' under the aegis of the Federal Emergency Management Agency (FEMA), has sponsored an effort to use computer technology - both large, time-sharing systems and small personal computers - to develop computer games which will help teach techniques of emergency management to the public at large. 24 references.

  13. Defining a core curriculum for education scholarship fellowships in emergency medicine.

    PubMed

    Coates, Wendy C; Lin, Michelle; Clarke, Samuel; Jordan, Jaime; Guth, Todd; Santen, Sally A; Yarris, Lalena M

    2012-12-01

    A trained cadre of medical education scholars with a focus on methodologically sound research techniques is needed to ensure development of innovations that can be translated to educational practice, rigorous evaluation of instructional strategies, and progress toward improving patient care outcomes. Most established educational programs are aimed at existing faculty members and focus primarily on the development of teaching and leadership skills. At the 2012 Academic Emergency Medicine (AEM) consensus conference, "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success," a breakout session was convened to develop training recommendations for postgraduate fellowship programs in medical education scholarship that would enable residency graduates to join academic faculties armed with the skills needed to perform research in medical education. Additionally, these graduates would enjoy the benefits of established mentorships. A group of 23 medical education experts collaborated to address the following objectives: 1) construct a formal needs assessment for fellowship training in medical education scholarship in emergency medicine (EM), 2) compare and contrast current education scholarship programs in both EM and non-EM specialties, and 3) develop a set of core curriculum guidelines for specialized fellowship training in medical education scholarship in EM. Fellowship-trained faculty need to be proficient in learner instruction and assessment, organizational leadership, curriculum development, educational methodology, and conducting generalizable hypothesis-driven research to improve patient care.

  14. [Hygiene and Public Health - Significance in Medicine and Society].

    PubMed

    Exner, M; Wiesmüller, G A

    2015-07-01

    The presented review attempts an historical overview on the development of Public Health in Germany with special reference to the medical specialty of Hygiene. This development is put in perspective to current international developments with a special emphasis on the programmatic work in the field of Public Health of the European Union.

  15. Emerging arboviruses and public health challenges in Brazil.

    PubMed

    Lima-Camara, Tamara Nunes

    2016-06-27

    Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

  16. Critical Care Medicine and Infectious Diseases: An Emerging Combined Subspecialty in the United States.

    PubMed

    Kadri, Sameer S; Rhee, Chanu; Fortna, Gregory S; O'Grady, Naomi P

    2015-08-15

    The recent rise in unfilled training positions among infectious diseases (ID) fellowship programs nationwide indicates that ID is declining as a career choice among internal medicine residency graduates. Supplementing ID training with training in critical care medicine (CCM) might be a way to regenerate interest in the specialty. Hands-on patient care and higher salaries are obvious attractions. High infection prevalence and antibiotic resistance in intensive care units, expanding immunosuppressed host populations, and public health crises such as the recent Ebola outbreak underscore the potential synergy of CCM-ID training. Most intensivists receive training in pulmonary medicine and only 1% of current board-certified intensivists are trained in ID. While still small, this cohort of CCM-ID certified physicians has continued to rise over the last 2 decades. ID and CCM program leadership nationwide must recognize these trends and the merits of the CCM-ID combination to facilitate creation of formal dual-training opportunities.

  17. The Women in Emergency Medicine Mentoring Program: An Innovative Approach to Mentoring

    PubMed Central

    Welch, Julie L.; Jimenez, Heather L.; Walthall, Jennifer; Allen, Sheryl E.

    2012-01-01

    Background Women in medicine report many gender-specific barriers to their career success and satisfaction, including a lack of mentors and role models. The literature calls for innovative strategies to enhance mentorship for women in medicine. Objective To describe the content, perceived value, and ongoing achievements of a mentoring program for women in emergency medicine. Methods The program offered mentoring for female faculty and residents in an academic emergency medicine department. Volunteers participated in group mentoring sessions using a mosaic of vertical and peer mentoring. Sessions focused on topics specific to women in medicine. An anonymous, electronic survey was sent to women who participated during 2004–2010 to assess the perceived value of the program and to collect qualitative feedback. Preliminary achievements fulfilling the program's goals were tracked. Results A total of 46 women (64%) completed the survey. The results showed a positive perceived value of the program (average, 4.65 on a 5-point Likert scale) in providing mentors and role models (4.41), in offering a supportive environment (4.39), in providing discussions pertinent to both personal (4.22) and professional development (4.22), while expanding networking opportunities (4.07). Notable achievements included work on the creation of a family leave policy, establishing lactation space, collaboration on projects, awards, and academic advancement. Conclusion This innovative model for mentoring women is perceived as a valuable asset to the academic department and residency. It offers the unique combination of expanding a female mentor pool by recruiting alumni and using a mosaic of vertical and peer mentoring. PMID:23997883

  18. Combating slavery in the 21st century: the role of emergency medicine.

    PubMed

    Chisolm-Straker, Makini; Richardson, Lynne D; Cossio, Tania

    2012-08-01

    Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. Prior to the intervention, 4.8% felt some degree of confidence in their ability to identify and 7.7% to treat a trafficked patient. After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.

  19. Precision Medicine With Point-of-Care Ultrasound: The Future of Personalized Pediatric Emergency Care.

    PubMed

    Kessler, David; Ng, Lorraine; Tessaro, Mark; Fischer, Jason

    2017-03-01

    The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient. In a similar vein, point-of-care ultrasound offers the emergency care provider an opportunity to move beyond protocols and provide precise medical care tailored to the acute needs of each ill or injured emergent patient. In this article, we explore several cutting-edge applications of point-of-care ultrasound that can help providers develop a personalized approach to resuscitation and emergent procedures in pediatrics.

  20. Public-private partnerships in translational medicine: concepts and practical examples.

    PubMed

    Luijten, Peter R; van Dongen, Guus A M S; Moonen, Chrit T; Storm, Gert; Crommelin, Daan J A

    2012-07-20

    The way forward in multidisciplinary research according to former NIH's director Elias Zerhouni is to engage in predictive, personalized, preemptive and participatory medicine. For the creation of the optimal innovation climate that would allow for such a strategy, public-private partnerships have been widely proposed as an important instrument. Public-private partnerships have become an important instrument to expedite translational research in medicine. The Netherlands have initiated three large public-private partnerships in the life sciences and health area to facilitate the translation of valuable basic scientific concepts to new products and services in medicine. The focus of these partnerships has been on drug development, improved diagnosis and regenerative medicine. The Dutch model of public-private partnership forms the blueprint of a much larger European initiative called EATRIS. This paper will provide practical examples of public-private partnerships initiated to expedite the translation of new technology for drug development towards the clinic. Three specific technologies are in focus: companion diagnostics using nuclear medicine, the use of ultra high field MRI to generate sensitive surrogate endpoints based on endogenous contrast, and MRI guidance for High Intensity Focused Ultrasound mediated drug delivery.

  1. [Relevant publications in ambulatory general internal medicine in 2007].

    PubMed

    Amstutz, R; Humair, J P; Junod Perron, N; Malacarne, S; Nyffenegger, L; Rieder, J P; Steiner, A S; Motamed, S

    2008-01-30

    Screening procedures for genital Chlamydia infection, cancer risks linked to oral contraceptives, indications and efficacy of HPV vaccination, and diagnostic tools for celiac disease in adults; these are just a few of the general practice themes that were reviewed and analysed in 2007 by residents and chief residents at the Community medicine and primary care Service of the Geneva University Hospitals. These commented summaries, intended for all our colleagues, constitute Geneva's contribution to the literature data base initiated in 2005 by chief residents in Lausanne.

  2. Science, humanism, judgement, ethics: person-centered medicine as an emergent model of modern clinical practice.

    PubMed

    Miles, Andrew

    2013-01-01

    The Medical University of Plovdiv (MUP) has as its motto 'Committed to humanity". But what does humanity in modern medicine mean? Is it possible to practise a form of medicine that is without humanity? In the current article, it is argued that modern medicine is increasingly being practised in a de-personalised fashion, where the patient is understood not as a unique human individual, a person, but rather as a subject or an object and more in the manner of a complex biological machine. Medicine has, it is contended, become distracted from its duty to care, comfort and console as well as to ameliorate, attenuate and cure and that the rapid development of medicine's scientific knowledge is, paradoxically, principally causative. Signal occurrences in the 'patient as a person' movement are reviewed, together with the emergence of the evidence-based medicine (EBM) and patient-centered care (PCC) movements. The characteristics of a model of medicine evolving in response to medicine's current deficiencies--person-centered healthcare (PCH)--are noted and described. In seeking to apply science with humanism, via clinical judgement, within an ethical framework, it is contended that PCH will prove to be far more responsive to the needs of the individual patient and his/her personal circumstances than current models of practice, so that neither a reductive anatomico-pathological, disease-centric model of illness (EBM), nor an aggressive patient-directed, consumerist form of care (PCC) is allowed continued dominance within modern healthcare systems. In conclusion, it is argued that PCH will enable affordable advances in biomedicine and technology to be delivered to patients within a humanistic framework of clinical practice that recognises the patient as a person and which takes full account of his/her stories, values, preferences, goals, aspirations, fears, worries, hopes, cultural context and which responds to his/her psychological, emotional, spiritual and social necessities

  3. The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

    PubMed

    Sheppard, Maria K

    2015-10-01

    Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries.

  4. A new entity for the negotiation of public procurement prices for patented medicines in Mexico

    PubMed Central

    Wirtz, Veronika J; Reich, Michael R; Terrazas, Paulina; Ortiz, Maki

    2012-01-01

    Abstract Problem As countries expand health insurance coverage, their expenditures on medicines increase. To address this problem, WHO has recommended that every country draw up a list of essential medicines. Although most medicines on the list are generics, in many countries patented medicines represent a substantial portion of pharmaceutical expenditure. Approach To help control expenditure on patented medicines, in 2008 the Mexican Government created the Coordinating Commission for Negotiating the Price of Medicines and other Health Inputs (CCPNM), whose role, as the name suggests, is to enter into price negotiations with drug manufacturers for patented drugs on Mexico’s list of essential medicines. Local setting Mexico’s public expenditure on pharmaceuticals has increased substantially in the past decade owing to government efforts to achieve universal health-care coverage through Seguro Popular, an insurance programme introduced in 2004 that guarantees access to a comprehensive package of health services and medicines. Relevant changes Since 2008, the CCPNM has improved procurement practices in Mexico’s public health institutions and has achieved significant price reductions resulting in substantial savings in public pharmaceutical expenditure. Lessons learnt The CCPNM has successfully changed the landscape of price negotiation for patented medicines in Mexico. However, it is also facing challenges, including a lack of explicit indicators to assess CCPNM performance; a shortage of permanent staff with sufficient technical expertise; poor coordination among institutions in preparing background materials for the annual negotiation process in a timely manner; insufficient communication among committees and institutions; and a lack of political support to ensure the sustainability of the CCPNM. PMID:23109747

  5. Applications In Emergency Response and Public Safety (Briefing Charts)

    DTIC Science & Technology

    2013-03-01

    disaster 3. Response – The actions taken my emergency services personnel and agencies to saves lives, protect property and the environment 4...taken to increase readiness and the ability to respond to a disaster 3. Response – The actions taken my emergency services personnel and agencies to

  6. Medication Overdoses at a Public Emergency Department in Santiago, Chile

    PubMed Central

    Aguilera, Pablo; Garrido, Marcela; Lessard, Eli; Swanson, Julian; Mallon, William K.; Saldias, Fernando; Basaure, Carlos; Lara, Barbara; Swadron, Stuart P.

    2016-01-01

    Introduction While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients’ self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO) that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile. Methods This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications. Results We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED) presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%). Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA) were the causative agents most commonly found, comprising 1,044 (87.2%) of all analyzed cases. Acetaminophen was involved in 81 (6.8%) cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine). Of 1,557 cases, six (0.39%) patients died. TCA were involved in two of these deaths. Conclusion Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a relatively low rate

  7. Enhancing the Relevance of Incident Management Systems in Public Health Emergency Preparedness: A Novel Conceptual Framework.

    PubMed

    Bochenek, Richard; Grant, Moira; Schwartz, Brian

    2015-08-01

    We outline a conceptual framework developed to meet the needs of public health professionals in the province of Ontario for incident management system-related education and training. By using visual models, this framework applies a public health lens to emergency management, introducing concepts relevant to public health and thereby shifting the focus of emergency preparedness from a strict "doctrine" to a more dynamic and flexible approach grounded in the traditional principles of incident management systems. These models provide a foundation for further exploration of the theoretical foundations for public health emergency preparedness in practice.

  8. 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.

  9. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    PubMed Central

    Stoneking, LR; Waterbrook, AL; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, KH; Adamas-Rappaport, W

    2016-01-01

    Background After emergency department (ED) discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit. Objectives To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency. Methods Our ED has two Emergency Medicine Residency Programs, University Campus (UC) and South Campus (SC). SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions. Results Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters – 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters – 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians

  10. Clinical medicine, public health and ecological health: a new basis for education and prevention?

    PubMed Central

    Schaller, Bernhard; Sandu, Nora

    2011-01-01

    In contrast to public health and the resolution to further increase the health care of the whole community in regions worldwide, current clinical medicine has its limits. Further improvement in public health – rather than individual diseases – can only be achieved by integrating new views into treatment. Some years ago, the concept of biopsychosocial medicine was integrated into patient treatment and is now generally accepted. Therefore the author describes here a new dimension to treatment and presents substantial evidence to include ecological health in this already existing concept. The problem of community education is discussed. PMID:22291784

  11. Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

    PubMed

    Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

    2017-02-03

    Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p < 0.001), and all in English. Handoff was streamlined from 7 possible pathways to 3. Most post-intervention survey respondents reported improved workflow (77.8%) and safety (83.3%); none reported patient harm. Respondents and observers noted reduced inefficiency (p < 0.05). Our standardized tool increased face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

  12. EMERGENCY RESPONSE FOR PUBLIC WATER SUPPLIES AFTER HURRICANE KATRINA

    EPA Science Inventory

    Hurricane Katrina resulted in damage and destruction to local water supplies in Mississippi and Louisiana affecting millions of people. Immediately following the devastation, a multidisciplinary team of 30 EPA emergency response, research, and water program personnel joined force...

  13. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

    ERIC Educational Resources Information Center

    Hilton, Warren

    2013-01-01

    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  14. Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

    PubMed

    Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

    2017-02-01

    The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

  15. The Emergence of the Dose–Response Concept in Biology and Medicine

    PubMed Central

    Calabrese, Edward J.

    2016-01-01

    A historical assessment of the origin of the dose–response in modern toxicology and its integration as a central concept in biology and medicine is presented. This article provides an overview of how the threshold, linear and biphasic (i.e., hormetic) dose–response models emerged in the late 19th and early 20th centuries and competed for acceptance and dominance. Particular attention is directed to the hormetic model for which a general description and evaluation is provided, including its historical basis, and how it was marginalized by the medical and pharmacology communities in the early decades of the 20th century. PMID:27929392

  16. The Emergence of the Dose-Response Concept in Biology and Medicine.

    PubMed

    Calabrese, Edward J

    2016-12-05

    A historical assessment of the origin of the dose-response in modern toxicology and its integration as a central concept in biology and medicine is presented. This article provides an overview of how the threshold, linear and biphasic (i.e., hormetic) dose-response models emerged in the late 19th and early 20th centuries and competed for acceptance and dominance. Particular attention is directed to the hormetic model for which a general description and evaluation is provided, including its historical basis, and how it was marginalized by the medical and pharmacology communities in the early decades of the 20th century.

  17. An agenda for increasing grant funding of emergency medicine education research.

    PubMed

    Choo, Esther K; Fernandez, Rosemarie; Hayden, Emily M; Schneider, Jeffrey I; Clyne, Brian; Ginsburg, Shiphra; Gruppen, Larry D

    2012-12-01

    Funding is a perennial challenge for medical education researchers. Through a consensus process, the authors developed a multifaceted agenda for increasing funding of education research in emergency medicine (EM). Priority agenda items include developing resources to increase the competitiveness of medical education research faculty in grant applications, identifying means by which departments may bolster their faculty's grant writing success, taking long-term steps to increase the number of grants available to education researchers in the field, and encouraging a shift in cultural attitudes toward education research.

  18. Poisoning in the United States: 2012 emergency medicine report of the National Poison Data System.

    PubMed

    Dart, Richard C; Bronstein, Alvin C; Spyker, Daniel A; Cantilena, Louis R; Seifert, Steven A; Heard, Stuart E; Krenzelok, Edward P

    2015-04-01

    Deaths from drug overdose have become the leading cause of injury death in the United States, where the poison center system is available to provide real-time advice and collect data about a variety of poisonings. In 2012, emergency medical providers were confronted with new poisonings, such as bath salts (substituted cathinones) and Spice (synthetic cannabinoid drugs), as well as continued trends in established poisonings such as from prescription opioids. This article addresses current trends in opioid poisonings; new substances implicated in poisoning cases, including unit-dose laundry detergents, bath salts, Spice, and energy drinks; and the role of poison centers in public health emergencies such as the Fukushima radiation incident.

  19. Emergency medicine in India: why are we unable to 'walk the talk'?

    PubMed

    David, Suresh S; Vasnaik, Mabel; T V, Ramakrishnan

    2007-08-01

    The largest democracy on earth, the second most populous country and one of the most progressive countries in the globe, India, has advanced tremendously in most conventional fields of Medicine. However, emergency medicine (EM) is a nascent specialty and is yet to receive an identity. Today, it is mostly practised by inadequately trained clinicians in poorly equipped emergency departments (EDs), with no networking. Multiple factors such as the size of the population, variation in standards of medical education, lack of pre-hospital medical systems and non-availability of health insurance schemes are some of the salient causes for this tardy response. The Indian medical system is governed by a central, regulatory body which is responsible for the introduction and monitoring of all specialties--the Medical Council of India (MCI). This organisation has not recognized EM as a distinct specialty, despite a decade of dogged attempts. Bright young clinicians who once demonstrated a keen interest in EM have eventually migrated to other conventional branches of medicine, due to the lack of MCI recognition and the lack of specialty status. The Government of India has launched a nationwide network of transport vehicles and first aid stations along the national highways to expedite the transfer of patients from a crash site. However, this system cannot be expected to decrease morbidity and mortality, unless there is a concurrent development of EDs. The present article intends to highlight factors that continue to challenge the handful of dedicated, full time emergency physicians who have tenaciously pursued the cause for the past decade. A three-pronged synchronous development strategy is recommended: (i) recognise the specialty of EM as a distinct and independent basic specialty; (ii) initiate postgraduate training in EM, thus enabling EDs in all hospitals to be staffed by trained Emergency physicians; and (iii) ensure that EMs are staffed by trained ambulance officers. The

  20. Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

    PubMed Central

    DelliFraine, Jami; Langabeer, James; King, Brent

    2010-01-01

    Objective To assess academic emergency medicine (EM) chairs’ perceptions of quality improvement (QI) training programs. Methods A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior, practice and outcomes, and any perceived barriers to implementing QI programs in the emergency department. Results The response rate to the survey was 69% (N = 59). 59.3% of respondents report that their hospital has a formal QI program for physicians. Chairs received training in a variety of QI programs. The type of QI program used by respondents was perceived as having no impact on goals achieved by QI (χ2 = 12.382; p = 0.260), but there was a statistically significant (χ2 = 14.383; p = 0.006) relationship between whether or not goals were achieved and academic EM chairs’ perceptions about return on investment for QI training. Only 22% of chairs responded that they have already made changes as a result of the QI training. 78.8% of EM chairs responded that quality programs could have a significant positive impact on their practice and the healthcare industry. Chairs perceived that QI programs had the most potential value in the areas of understanding and reducing medical errors and improving patient flow and throughput. Other areas of potential value of QI include improving specific clinical indicators and standardizing physician care. Conclusion Academic EM chairs perceived that QI programs were an effective way to drive needed improvements. The results suggest that there is a high level of interest in QI but a low level of adoption of training and implementation. PMID:21293770

  1. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    PubMed Central

    2011-01-01

    Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to

  2. A review of newly approved antibiotics and antibiotics reserved for resistant infections: Implications for emergency medicine.

    PubMed

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

    2016-10-17

    Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical. Increasing rates of antibiotic resistance, drug allergies, and antibiotic shortages further complicates the choice of antibiotics. Patients may have a history of prior resistant infections or culture data indicating that common first-line antibiotics used in the ED may be ineffective. In recent years, there have been several new antibiotic approvals as well as renewed interest in second and third line antibiotics because of the aforementioned concerns. In addition, several newly approved antibiotics have the advantage of being administered once weekly or even as a single infusion, which has the potential to decrease hospitalizations and healthcare costs. This article reviews newly approved antibiotics and antibiotics used to treat resistant infections with a focus on implications for emergency medicine.

  3. A report on the Academic Emergency Medicine 2015 consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization".

    PubMed

    Gunn, Martin L; Marin, Jennifer R; Mills, Angela M; Chong, Suzanne T; Froemming, Adam T; Johnson, Jamlik O; Kumaravel, Manickam; Sodickson, Aaron D

    2016-08-01

    In May 2015, the Academic Emergency Medicine consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization" was held. The goal of the conference was to develop a high-priority research agenda regarding emergency diagnostic imaging on which to base future research. In addition to representatives from the Society of Academic Emergency Medicine, the multidisciplinary conference included members of several radiology organizations: American Society for Emergency Radiology, Radiological Society of North America, the American College of Radiology, and the American Association of Physicists in Medicine. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Through a multistep consensus process, participants developed targeted research questions for future research in six content areas within emergency diagnostic imaging: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use.

  4. Trends in publication of evidence-based Traditional Iranian medicine in endocrinology and metabolic disorders

    PubMed Central

    2013-01-01

    Traditional Iranian medicine (TIM) is a main part of complementary and alternative medicine (CAM). The popularity and use of alternative therapies are increasing due to adverse effects and ineffectiveness of pharmacologic treatments in some cases. Herbal medicine is one of the methods of traditional therapy that plays a key role in the treatment of various diseases specifically in diabetes mellitus, hyperlipidemia and obesity that are growing rapidly in the world. In this article, trends of scientific publications of Iranian medicine in endocrinology and metabolic disorders have been investigated. Our data show that the numbers of related researches have uptrend from 2000 till now. These data are valuable to pharmaceutical companies to get the idea to invest and produce effective drugs. PMID:24355592

  5. Competencies for public health and interprofessional education in accreditation standards of complementary and alternative medicine disciplines.

    PubMed

    Brett, Jennifer; Brimhall, Joseph; Healey, Dale; Pfeifer, Joseph; Prenguber, Marcia

    2013-01-01

    This review examines the educational accreditation standards of four licensed complementary and alternative medicine (CAM) disciplines (naturopathic medicine, chiropractic health care, acupuncture and oriental medicine, and massage therapy), and identifies public health and other competencies found in those standards that contribute to cooperation and collaboration among the health care professions. These competencies may form a foundation for interprofessional education. The agencies that accredit the educational programs for each of these disciplines are individually recognized by the United States Department (Secretary) of Education. Patients and the public are served when healthcare practitioners collaborate and cooperate. This is facilitated when those practitioners possess competencies that provide them the knowledge and skills to work with practitioners from other fields and disciplines. Educational accreditation standards provide a framework for the delivery of these competencies. Requiring these competencies through accreditation standards ensures that practitioners are trained to optimally function in integrative clinical care settings.

  6. A history of the future: the emergence of contemporary anti-ageing medicine.

    PubMed

    Everts Mykytyn, Courtney

    2010-02-01

    The emergence of anti-ageing medicine over the past 20 years has posed tremendous challenges for the understanding of ageing and the concomitant responsibilities of biomedicine. Though highly contentious and loosely organised at best, anti-ageing targets ageing for biomedical intervention. This article examines a history of anti-ageing in the United States from 1993 to 2008, outlining its evolution from a scientific 'backwater' to a field with such promise that many within and outside the field believe efficacious therapies are an inevitability. In large part, the language of anti-ageing has shifted from predictions to expectations; it has become less a question of 'if' and more a question of 'when' and 'how' this rhetorical shift is directly linked with increasing legitimacy constructed upon a complex web of factors including mounting practitioner involvement, research interest, media attention, and popular desire. In this article I briefly review this history alongside the strategic histories marshalled by the various proponents and opponents to support their claims of legitimacy. The history of anti-ageing medicine is one of an emerging scientific and clinical practice as well as a history of an idea that has very recently made its way out of science fiction and into science future.

  7. African American and Latino Enrollment Trends among Medicine, Law, Business, and Public Affairs Graduate Programs

    ERIC Educational Resources Information Center

    de la Garza, Rodolfo; Moghadam, Sepehr Hejazi

    2008-01-01

    The purpose of this Tomas Rivera Policy Institute (TRPI) report is twofold: to provide an analysis of the enrollment trends for African American and Latino students among graduate professional programs in the fields of medicine, business, law, and public affairs, and to present other relevant data pertaining to African American and Latino students…

  8. Transforming Epidemiology for 21st Century Medicine and Public Health

    SciTech Connect

    Khoury, Muin J; Lam, Tram Kim; Ioannidis, John; Hartge, Patricia; Spitz, Margaret R.; Buring, Julie E.; Chanock, Stephen J.; Tourassi, Georgia; Zauber, Ann; Schully, Sheri D

    2013-01-01

    n 2012, the National Cancer Institute (NCI) engaged the scientific community to provide a vision for cancer epidemiology in the 21st century. Eight overarching thematic recommendations, with proposed corresponding actions for consideration by funding agencies, professional societies, and the research community emerged from the collective intellectual discourse. The themes are (i) extending the reach of epidemiology beyond discovery and etiologic research to include multilevel analysis, intervention evaluation, implementation, and outcomes research; (ii) transforming the practice of epidemiology by moving toward more access and sharing of protocols, data, metadata, and specimens to foster collaboration, to ensure reproducibility and replication, and accelerate translation; (iii) expanding cohort studies to collect exposure, clinical, and other information across the life course and examining multiple health-related endpoints; (iv) developing and validating reliable methods and technologies to quantify exposures and outcomes on a massive scale, and to assess concomitantly the role of multiple factors in complex diseases; (v) integrating big data science into the practice of epidemiology; (vi) expanding knowledge integration to drive research, policy, and practice; (vii) transforming training of 21st century epidemiologists to address interdisciplinary and translational research; and (viii) optimizing the use of resources and infrastructure for epidemiologic studies. These recommendations can transform cancer epidemiology and the field of epidemiology, in general, by enhancing transparency, interdisciplinary collaboration, and strategic applications of new technologies. They should lay a strong scientific foundation for accelerated translation of scientific discoveries into individual and population health benefits.

  9. Transforming Epidemiology for 21st Century Medicine and Public Health

    PubMed Central

    Khoury, Muin J.; Lam, Tram Kim; Ioannidis, John P.A.; Hartge, Patricia; Spitz, Margaret R.; Buring, Julie E.; Chanock, Stephen J.; Croyle, Robert T.; Goddard, Katrina A.; Ginsburg, Geoffrey S.; Herceg, Zdenko; Hiatt, Robert A.; Hoover, Robert N.; Hunter, David J.; Kramer, Barnet S.; Lauer, Michael S.; Meyerhardt, Jeffrey A.; Olopade, Olufunmilayo I.; Palmer, Julie R.; Sellers, Thomas A.; Seminara, Daniela; Ransohoff, David F.; Rebbeck, Timothy R.; Tourassi, Georgia; Winn, Deborah M.; Zauber, Ann; Schully, Sheri D.

    2013-01-01

    In 2012, the National Cancer Institute (NCI) engaged the scientific community to provide a vision for cancer epidemiology in the 21st century. Eight overarching thematic recommendations, with proposed corresponding actions for consideration by funding agencies, professional societies, and the research community emerged from the collective intellectual discourse. The themes are (i) extending the reach of epidemiology beyond discovery and etiologic research to include multilevel analysis, intervention evaluation, implementation, and outcomes research; (ii) transforming the practice of epidemiology by moving towards more access and sharing of protocols, data, metadata, and specimens to foster collaboration, to ensure reproducibility and replication, and accelerate translation; (iii) expanding cohort studies to collect exposure, clinical and other information across the life course and examining multiple health-related endpoints; (iv) developing and validating reliable methods and technologies to quantify exposures and outcomes on a massive scale, and to assess concomitantly the role of multiple factors in complex diseases; (v) integrating “big data” science into the practice of epidemiology; (vi) expanding knowledge integration to drive research, policy and practice; (vii) transforming training of 21st century epidemiologists to address interdisciplinary and translational research; and (viii) optimizing the use of resources and infrastructure for epidemiologic studies. These recommendations can transform cancer epidemiology and the field of epidemiology in general, by enhancing transparency, interdisciplinary collaboration, and strategic applications of new technologies. They should lay a strong scientific foundation for accelerated translation of scientific discoveries into individual and population health benefits. PMID:23462917

  10. Transforming epidemiology for 21st century medicine and public health.

    PubMed

    Khoury, Muin J; Lam, Tram Kim; Ioannidis, John P A; Hartge, Patricia; Spitz, Margaret R; Buring, Julie E; Chanock, Stephen J; Croyle, Robert T; Goddard, Katrina A; Ginsburg, Geoffrey S; Herceg, Zdenko; Hiatt, Robert A; Hoover, Robert N; Hunter, David J; Kramer, Barnet S; Lauer, Michael S; Meyerhardt, Jeffrey A; Olopade, Olufunmilayo I; Palmer, Julie R; Sellers, Thomas A; Seminara, Daniela; Ransohoff, David F; Rebbeck, Timothy R; Tourassi, Georgia; Winn, Deborah M; Zauber, Ann; Schully, Sheri D

    2013-04-01

    In 2012, the National Cancer Institute (NCI) engaged the scientific community to provide a vision for cancer epidemiology in the 21st century. Eight overarching thematic recommendations, with proposed corresponding actions for consideration by funding agencies, professional societies, and the research community emerged from the collective intellectual discourse. The themes are (i) extending the reach of epidemiology beyond discovery and etiologic research to include multilevel analysis, intervention evaluation, implementation, and outcomes research; (ii) transforming the practice of epidemiology by moving toward more access and sharing of protocols, data, metadata, and specimens to foster collaboration, to ensure reproducibility and replication, and accelerate translation; (iii) expanding cohort studies to collect exposure, clinical, and other information across the life course and examining multiple health-related endpoints; (iv) developing and validating reliable methods and technologies to quantify exposures and outcomes on a massive scale, and to assess concomitantly the role of multiple factors in complex diseases; (v) integrating "big data" science into the practice of epidemiology; (vi) expanding knowledge integration to drive research, policy, and practice; (vii) transforming training of 21st century epidemiologists to address interdisciplinary and translational research; and (viii) optimizing the use of resources and infrastructure for epidemiologic studies. These recommendations can transform cancer epidemiology and the field of epidemiology, in general, by enhancing transparency, interdisciplinary collaboration, and strategic applications of new technologies. They should lay a strong scientific foundation for accelerated translation of scientific discoveries into individual and population health benefits.

  11. Emergency Management in Public Administration Education. Volume 2, Number 1

    DTIC Science & Technology

    1985-01-01

    of the 1976 Earthquake in the Soca River Basin," in Social and Economic Aspects of Earthquakes: Proceedings of the Third International Conference...Uses, Institute of Behavioral Science, Boulder, Colorado: Univ-ersity of Colorado, 1976 . Baltz, Duane, "Applying Interlocal Agreements to Emergency...Research Findings, Issues, Implications for Organizational Policy," Boulder, Colorado: Institute of Behavioral Science, University of Colorado, 1976

  12. Addressing the gap between public health emergency planning and incident response

    PubMed Central

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response.

  13. Emerging markets for satellite data communications in the public service

    NASA Technical Reports Server (NTRS)

    Potter, J. G.

    1978-01-01

    The paper discusses some of the current and potential markets for satellite data communications as projected by the Public Service Satellite Consortium (PSSC). Organizations in the public service sector are divided into three categories, depending on their expected benefits and organizational changes due to increased satellite telecommunications use: A - modest institutional adjustments are necessary and significant productivity gains are likely; B - institutional requirements picture is promising, but more information is needed to assess benefits and risk; and C - major institutional adjustments are needed, risks are high but possible benefits are high. These criteria are applied to the U.S. health care system, continuing education, equipment maintenance, libraries, environmental monitoring, and other potential markets. The potential revenues are seen to be significant, but what is needed is a cooperative effort by common carriers and major public service institutions to aggregate the market.

  14. Electronic strategies for information and research: cyberNephrology/cyberMedicine in the emerging world.

    PubMed

    Solez, Kim; Hales, Michele; Katz, Sheila Moriber

    2005-09-01

    Communication and medicine have evolved together. Internet resources now provide an unprecedented opportunity to provide health assistance to the developing world. The International Society of Nephrology Informatics Commission and National Kidney Foundation cyberNephrology initiative (http://www.cybernephrology.org) have created e-mail discussion groups (e.g., NEPHROL, NEPHKIDS, and so forth) and online texts and web resources (e.g., the Schrier Atlas: http://www.kidneyatlas.org) that are, in many respects, ahead of other areas of medicine. On the other hand, nephrology is quite behind in its embrace of some specific communications initiatives that could benefit emerging nations: the Health InterNetwork Access to Research Initiative program, which provides free full-text access to medical journals and books in poorer countries; the Global Health Network Supercourse, which provides specially designed online lectures for the developing world; and Internet2/Abilene and similar research networks around the world, which provide reliable, guaranteed bandwidth for high-quality Internet videoconferencing as an alternative to face-to-face lectures and meetings. The intent of many educational ventures in nephrology, particularly in the clinical practice guideline realm (National Kidney Foundation Kidney Disease Outcomes Quality Initiative, Kidney Disease Improving Global Outcomes, and so forth), is not just to disseminate information but to change human behavior: physician practice and referral patterns, patient compliance, and so forth. Concepts from the worlds of marketing and entertainment, where the science of changing human behavior is highly evolved, can be used to create high-impact, educational offerings to promote health. They can also be highly beneficial to share Internet educational innovations and future vision across boundaries of medical specialties, which is part of the intent of the cyberMedicine joint venture (http://www.cyber-medicine.org).

  15. Preparing racially and ethnically diverse communities for public health emergencies.

    PubMed

    Andrulis, Dennis P; Siddiqui, Nadia J; Gantner, Jenna L

    2007-01-01

    The tragedy of Hurricane Katrina in New Orleans confirmed that effective implementation of public health preparedness programs and policies will require compliance from all racial and ethnic populations. This study reviews current resources and limitations and suggests future directions for integrating diverse communities into related strategies. It documents research and interventions, including promising models and practices that address preparedness for minorities. However, findings reveal a general lack of focus on diversity and suggest that future preparedness efforts need to fully integrate factors related to race, culture, and language into risk communication, public health training, measurement, coordination, and policy at all levels.

  16. QOI8/456: Quality Criteria for Electronic Publications in Medicine

    PubMed Central

    Schulz, S; Auhuber, T; Schrader, U; Koop, A; Kreutz, R; Oppermann, R; Simm, H; Klar, R

    1999-01-01

    If compared with printed media, the prospect for the success of health-related WWW publications lies in the added value of motivation and efficacy, due to the multi-modal coding of contents, in the possibility to provide search facilities and the flexibility of interaction with the user. An important advantage over the off-line distribution of disks or CD-ROMs is the automated diffusion and update of the contents. Whereas more and more medical WWW sites are launched, their acceptance and utilisation, especially in medical education is still unsatisfactory. Obviously, one reason for this phenomenon is the lack of quality. Many authors, developers and software publishers ignore that the design of high-quality electronic publications is a cost-intensive process. As key qualifications we identify: domain competence, software engineering skills, media production proficiency, GUI design competence, and didactic qualifications. On behalf of the German Association of Medical Informatics, Biometry and Epidemiology (GMDS), the authors have co-ordinated the development of a catalogue of "Quality Criteria for Electronic Publications in Medicine". This catalogue defines as Electronic Publications in Medicine any software containing health-related generic knowledge, with WWW publications being an important group. The criteria catalogue is divided into the sections contents, technical aspects, coding of information, ergonomy, dialogue and didactics. According to these items, typical faults and deficiencies of medical electronic publications are elucidated and possible solutions are given. Our criteria are intended to support the formative evaluation during the development of electronic publications, and to provide a basis for the summative evaluation of medical WWW and offline publications. The catalogue of "Quality Criteria for Electronic Publications in Medicine" is available in German, English, Portuguese and Spanish, at: http://www.imbi.uni-freiburg.de/medinf/gmdsqc/.

  17. Can Emergency Medicine Residents Reliably Use the Internet to Answer Clinical Questions?

    PubMed Central

    Krause, Richard; Moscati, Ronald; Halpern, Shravanti; Schwartz, Diane G; Abbas, June

    2011-01-01

    Introduction The study objective was to determine the accuracy of answers to clinical questions by emergency medicine (EM) residents conducting Internet searches by using Google. Emergency physicians commonly turn to outside resources to answer clinical questions that arise in the emergency department (ED). Internet access in the ED has supplanted textbooks for references because it is perceived as being more up to date. Although Google is the most widely used general Internet search engine, it is not medically oriented and merely provides links to other sources. Users must judge the reliability of the information obtained on the links. We frequently observed EM faculty and residents using Google rather than medicine-specific databases to seek answers to clinical questions. Methods Two EM faculties developed a clinically oriented test for residents to take without the use of any outside aid. They were instructed to answer each question only if they were confident enough of their answer to implement it in a patient-care situation. Questions marked as unsure or answered incorrectly were used to construct a second test for each subject. On the second test, they were instructed to use Google as a resource to find links that contained answers. Results Thirty-three residents participated. The means for the initial test were 32% correct, 28% incorrect, and 40% unsure. On the Google test, the mean for correct answers was 59%; 33% of answers were incorrect and 8% were unsure. Conclusion EM residents' ability to answer clinical questions correctly by using Web sites from Google searches was poor. More concerning was that unsure answers decreased, whereas incorrect answers increased. The Internet appears to have given the residents a false sense of security in their answers. Innovations, such as Internet access in the ED, should be studied carefully before being accepted as reliable tools for teaching clinical decision making. PMID:22224135

  18. Tulane University School of Public Health and Tropical Medicine 100th anniversary. Introduction. From hygiene and tropical medicine to global health.

    PubMed

    Buekens, Pierre

    2012-10-01

    The author reviews the history of the Tulane School of Public Health and Tropical Medicine. In 1912, Dr. Creighton Wellman published a groundbreaking paper entitled "The New Orleans School of Tropical Medicine and Hygiene," outlining a clear plan for a new independent school of public health. He became the founding dean of the Tulane School of Hygiene and Tropical Medicine. Dr. Wellman had spent 9 years practicing medicine in Angola and graduated from the London School of Tropical Medicine before launching a career in tropical medicine in the United States. Tulane already had a formal course of hygiene established as early as 1881. The founding of Tulane School of Hygiene and Tropical Medicine was made possible by a gift from Samuel Zemurray, who would become the president of the United Fruit Company. In January of 1914, Dr. Wellman abruptly left New Orleans to live in Brazil. The school lost its independence in 1919 and again became part of the School of Medicine until 1967. The school initiated by Dr. Wellman is the foundation on which today's Tulane School of Public Health and Tropical Medicine is built.

  19. 77 FR 43373 - Emergency Clearance; Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... From the Federal Register Online via the Government Publishing Office NATIONAL SCIENCE FOUNDATION... Budget; Notice AGENCY: National Science Foundation. ACTION: Emergency Clearance: Public Information... addressed to Suzanne Plimpton, Reports Clearance Officer, National Science Foundation, 4201 Wilson Blvd.,...

  20. Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

    PubMed

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging use and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified before the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with the planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were a total of 164 individuals involved in the conference and spanned various specialties, including general emergency medicine, pediatric emergency medicine, radiology, surgery, medical physics, and the decision sciences.

  1. Avicenna's Canon of Medicine: a look at health, public health, and environmental sanitation.

    PubMed

    Saffari, Mohsen; Pakpour, Amir H

    2012-12-01

    Avicenna, a renowned Persian Muslim scientist has written numerous scientific papers and valuable medical books that are respected worldwide. For centuries his masterpiece, the "Canon of Medicine", has been used as a major medical reference. The Canon, as a prime encyclopedia on medicine is comprised of five books. In the introduction to the Canon, Avicenna has described the purpose of medicine as the preservation of health if it is already attained and its restoration when it is lost. He defines health as a trait or state, which results in the normal functioning of the human body and presumes that health is a steady state, whilst disease is more of a variable concept. Thus whenever we depart from a healthy state, we approach disease. A comparison of current views regarding definitions of health, disease and their components as defined by Avicenna could open new horizons for ancient, traditional medicine. The Canon contains numerous implications concerning the infrastructures of public health-related issues. For example the specifications of healthy water and air are well described in the "Canon of Medicine". To enable a better understanding of Avicenna's viewpoints about public health, we have briefly reviewed his perspective on the topics of health, disease, and environmental sanitation concerning water and air.

  2. Ethical decision making in a crisis: a case study of ethics in public health emergencies.

    PubMed

    Thomas, James C; MacDonald, Pia D M; Wenink, Emily

    2009-01-01

    Public health emergencies, such as hurricanes and the constant threat of an influenza pandemic, present public health responders with many ethical issues and little time to think them through. We interviewed 13 responders in the Epidemiology Section of the North Carolina Division of Public Health to learn how they have identified and addressed ethical issues in public health emergencies affecting the state and to identify potential means of improving those processes for North Carolina and other states. The Epidemiology Section staff demonstrated an awareness of several ethical issues in public health emergencies and an ability to identify and address issues through group interactions. However, few study participants in the section had received any training in public health ethics. Perhaps for this reason, the range of ethical issues they identified excluded several mentioned in the Public Health Code of Ethics. Moreover, their ethical decision making could be enhanced by a more detailed understanding of the ethical issues they named. We recommend seven practical steps that the Epidemiology Section can take to improve their ability to identify and address ethical issues in a public health emergency. The recommendations are likely relevant to many state, city, and county public health departments throughout the United States.

  3. Florida International University: development and accreditation of Miami's Public College of Medicine.

    PubMed

    Rock, John A; Simpson, Joe Leigh; Dambach, George; O'Leary, J Patrick; Markham, Sanford; Bagby, Larry; Seecharan, Khaleel; Berkman, Ronald M

    2009-10-01

    Anticipating pressing health care needs in the region, Florida International University (FIU) proposed the FIU College of Medicine (COM), which was approved by the Florida Board of Governors in March 2006. The FIU COM provides a program of study enabling graduates to pursue a wide spectrum of professional careers. This includes careers in general and subspecialty private practice, academic medicine, public service, health care, and public policy leadership. Irrespective of career choice, the special emphasis of the FIU COM mission is its focus on community health in a diverse metropolitan region. Clinical facilities are met through a public partner and multiple private hospital affiliations. Educational objectives are organized into five strands reflecting the breadth of medical education and running concurrently through the four-year curriculum: (1) human biology, (2) disease, illness, and injury, (3) clinical medicine, (4) professional development, and (5) medicine and society. Founding teaching faculty with expertise in the core basic sciences will not only introduce core scientific concepts during the initial seven months but reinforce these same concepts during organ system integrated courses and clerkships. The Neighborhood Health Education Learning Program is an FIU COM innovation in which each medical student is a member of a team that throughout the four-year curriculum identifies and addresses health care needs and factors affecting health outcomes. Preliminary approval of FIU COM was conferred in February 2008, with the first cohort of 40 students matriculating in August 2009.

  4. Public Health Emergency Management Within the Department of Defense

    DTIC Science & Technology

    2016-06-07

    condition of exemption or release from restriction of movement to submit to vaccination or treatment diagnostics as necessary to prevent transmitting a...communicable disease and enhance public ENCLOSURE 3 17 DoDI 6200.03, March 5, 2010 health and safety. The submission to vaccination or treatment...diagnostics may be a requirement to return to work or gain access to a DoD installation or facility. Qualified personnel shall perform vaccination and

  5. Emergency Planning for Dams: Bibliography and Abstracts of Selected Publications,

    DTIC Science & Technology

    1982-01-01

    Psychology . No. 2 (1971), pp. 187-203. Dynes, Russell R. Organizational Involvement & Changes in Community Structure in Disaster. Disaster Research Center, The...DAMS BIBLIOGRAPHY AND ABSTRACTS OF SELECTED PUBLICATIONS DTIC, JUL 3 0 198 JANUARY 1082 41E THE HYDROLOGIC ENGINEERING CENTER * research *training U.S...Hydrologic Engineering Center 609 Second Street, Davis, California 95616 II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE January 1982 IS. HUMBER

  6. 75 FR 370 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... [Document Identifier: CMS-10310] Emergency Clearance: Public Information Collection Requirements Submitted... reasonably comply with the normal clearance procedures due to an unexpected event as stated in 5 CFR 1320.13... processed under the emergency clearance process. Approval of this package is essential in order to...

  7. Sources and magnitude of occupational and public exposures from nuclear medicine procedures

    SciTech Connect

    1996-03-11

    This Report addresses the sources of exposures incurred in the practice of nuclear medicine and provides the necessary data to evaluate the magnitude of exposures to those directly associated with that practice and to those who provide nursing care to the patients containing radiopharmaceuticals. Exposure to members of the public are also addressed. The primary emphasis of this Report is on these individuals and not on the patient, since the patient receives the direct benefit from the nuclear medicine procedure. It is recognized that the patient also receives the bulk of any potential radiation decrement.

  8. Application of nanomedicine in emergency medicine; Point-of-care testing and drug delivery in twenty - first century

    PubMed Central

    2012-01-01

    Abstract The application of emerging nanotechnology to the practice of medicine represents a frontier of nanomedicine. Nanomedicine has been defined as a science which emphasizes the use of nanoscale tools in conjunction with background knowledge of the human body for medical diagnosis and treatment. Application of nanomedicine in EM may give EM providers the opportunity to diagnose and treat life-threatening diseases in a shorter period of time. These applications include diagnostic utilities, preventive medicine, targeted pharmacotherapy, and tissue regeneration. PMID:23351236

  9. Do emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool?

    PubMed

    Fredette, Jenna; O'Brien, Corinne; Poole, Christy; Nomura, Jason

    2015-04-01

    Experiential learning theory and the Kolb Learning Style Inventory (Kolb LSI) have influenced educators worldwide for decades. Knowledge of learning styles can create efficient learning environments, increase information retention, and improve learner satisfaction. Learning styles have been examined in medicine previously, but not specifically with Emergency Medicine (EM) residents and attendings. Using the Kolb LSI, the learning styles of Emergency Medicine residents and attendings were assessed. The findings showed that the majority of EM residents and attendings shared the accommodating learning style. This result was different than prior studies that found the majority of medical professionals had a converging learning style and other studies that found attendings often have different learning styles than residents. The issue of learning styles among emergency medical residents and attendings is important because learning style knowledge may have an impact on how a residency program structures curriculum and how EM residents are successfully, efficiently, and creatively educated.

  10. When an event sparks behavior change: an introduction to the sentinel event method of dynamic model building and its application to emergency medicine.

    PubMed

    Boudreaux, Edwin D; Bock, Beth; O'Hea, Erin

    2012-03-01

    Experiencing a negative consequence related to one's health behavior, like a medical problem leading to an emergency department (ED) visit, can promote behavior change, giving rise to the popular concept of the "teachable moment." However, the mechanisms of action underlying this process of change have received scant attention. In particular, most existing health behavior theories are limited in explaining why such events can inspire short-term change in some and long-term change in others. Expanding on recommendations published in the 2009 Academic Emergency Medicine consensus conference on public health in emergency medicine (EM), we propose a new method for developing conceptual models that explain how negative events, like medical emergencies, influence behavior change, called the Sentinel Event Method. The method itself is atheoretical; instead, it defines steps to guide investigations that seek to relate specific consequences or events to specific health behaviors. This method can be used to adapt existing health behavior theories to study the event-behavior change relationship or to guide formulation of completely new conceptual models. This paper presents the tenets underlying the Sentinel Event Method, describes the steps comprising the process, and illustrates its application to EM through an example of a cardiac-related ED visit and tobacco use.

  11. [Environmental medicine in public health service--a social responsibility and its consequences].

    PubMed

    Thriene, B

    2001-02-01

    The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.

  12. Chemical mutagenesis: an emerging issue for public health.

    PubMed Central

    Claxton, L D; Barry, P Z

    1977-01-01

    Chemical mutagens are recognized as prevalent in the environment and a potential threat to the health of future generations. This paper presents an overview of chemical mutagenesis as an issue for public health. Several problems in the determination of risk to human populations are discussed, including difficulties of extrapolating scientific data to humans, the latency period between exposure and recognizable genetic damage, and the large number of chemicals which must be tested. Test systems are described. Possibilities of control through federal regulation are discussed. PMID:911015

  13. 77 FR 14807 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ... HUMAN SERVICES Centers for Medicare and Medicaid Services Emergency Clearance: Public Information... section 1862(a)(1)(A) of the Social Security Act. We cannot reasonably comply with the normal clearance procedures in that public harm is reasonably likely to result if normal clearance procedures are followed...

  14. 76 FR 63302 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... Services [Document Identifier CMS-10379] Emergency Clearance: Public Information Collection Requirements... comply with the normal clearance procedures in that public harm is reasonably likely to result if normal clearance procedures are followed as stated in 5 CFR 1320.13(a)(2)(i). The approval of this data...

  15. 76 FR 76737 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... [Document Identifier CMS-10417] Emergency Clearance: Public Information Collection Requirements Submitted to... section 1862(a)(1)(A) of the Social Security Act. We cannot reasonably comply with the normal clearance procedures in that public harm is reasonably likely to result if normal clearance procedures are followed...

  16. Emergency Medical Services: Public Education Manual. A How-To-Do-It Guide.

    ERIC Educational Resources Information Center

    Huff, Hugh

    Using the systematic plan of the Public Education Project developed in Region J of North Carolina as its model, this guide presents in detail seven major steps in organizing a public education project for emergency medical services: (1) assessing needs; (2) survey methodology; (3) determining objectives; (4) media usage--both mass media and…

  17. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    PubMed Central

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated. PMID:25635201

  18. Potential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.

    PubMed

    Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A

    2016-10-01

    Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.

  19. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    PubMed

    Heng, Kenneth Wj

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated.

  20. Creating educational leaders: experiences with two education fellowships in emergency medicine.

    PubMed

    Yarris, Lalena M; Coates, Wendy C

    2012-12-01

    Academic physicians aiming to build careers on the scholarship of teaching require specific career development opportunities designed to provide the skills necessary for successful advancement and promotion as clinician-educators and scholars. Completing this training prior to embarking on an academic career may facilitate a smooth transition to a faculty position and establish mentoring networks and research collaboratives. This article describes two pilot medical education fellowships that have been successfully implemented in separate and unique departments of emergency medicine (EM). By comparing and contrasting the curricula and incorporating the experiences of graduating 10 EM education fellows over the past decade, the authors propose a fellowship structure that may be adapted to meet the needs of medical educators in a broad variety of fields and disciplines.

  1. Helicopter Evacuation Following a Rural Trauma: An Emergency Medicine Simulation Scenario Using Innovative Simulation Technology

    PubMed Central

    Whalen, Desmond; Harty, Chris; Ravalia, Mohamed; Renouf, Tia; Alani, Sabrina; Brown, Robert

    2016-01-01

    The relevance of simulation as a teaching tool for medical professionals working in rural and remote contexts is apparent when low-frequency, high-risk situations are considered. Simulation training has been shown to enhance learning and improve patient outcomes in urban settings. However, there are few simulation scenarios designed to teach rural trauma management during complex medical transportation. In this technical report, we present a scenario using a medevac helicopter (Replica of Sikorsky S-92 designed by Virtual Marine Technology, St. John's, NL) at a rural community. This case can be used for training primary care physicians who are working in a rural or remote setting, or as an innovative addition to emergency medicine and pre-hospital care training programs. PMID:27081585

  2. Trauma registries: history, logistics, limitations, and contributions to emergency medicine research.

    PubMed

    Zehtabchi, Shahriar; Nishijima, Daniel K; McKay, Mary Pat; Mann, N Clay

    2011-06-01

    Trauma registries have been designed to serve a number of purposes, including quality improvement, injury prevention, clinical research, and policy development. Since their inception over 30 years ago, there are increasingly more institutions with trauma registries, many of which submit data to a national trauma registry. The goal of this review is to describe the history, logistics, and characteristics of trauma registries and their contribution to emergency medicine and trauma research. Discussed in this review are the limitations of trauma registries, such as variability in quality and type of the collected data, absence of data pertaining to long-term and functional outcomes, prehospital information, and complications as well as other methodologic obstacles limiting the utility of registry data in clinical and epidemiologic research.

  3. Helicopter Evacuation Following a Rural Trauma: An Emergency Medicine Simulation Scenario Using Innovative Simulation Technology.

    PubMed

    Whalen, Desmond; Harty, Chris; Ravalia, Mohamed; Renouf, Tia; Alani, Sabrina; Brown, Robert; Dubrowski, Adam

    2016-03-08

    The relevance of simulation as a teaching tool for medical professionals working in rural and remote contexts is apparent when low-frequency, high-risk situations are considered. Simulation training has been shown to enhance learning and improve patient outcomes in urban settings. However, there are few simulation scenarios designed to teach rural trauma management during complex medical transportation. In this technical report, we present a scenario using a medevac helicopter (Replica of Sikorsky S-92 designed by Virtual Marine Technology, St. John's, NL) at a rural community. This case can be used for training primary care physicians who are working in a rural or remote setting, or as an innovative addition to emergency medicine and pre-hospital care training programs.

  4. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study

    PubMed Central

    Nakhjavan-Shahraki, Babak; Baikpour, Masoud; Yousefifard, Mahmoud; Nikseresht, Zahra Sadat; Abiri, Samaneh; Mirzay Razaz, Jalaledin; Faridaalaee, Gholamreza; Pouraghae, Mahboob; Shirzadegan, Sahar; Hosseini, Mostafa

    2017-01-01

    Introduction: Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED). Methods: In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016. The discriminatory power and calibration of the models were calculated and compared using STATA 11. Results: 2148 patients with the mean age of 39.50±17.27 years were studied (75.56% males). The area under the curve of REMS and RAPS in predicting in-hospital mortality were calculated to be 0.93 (95% CI: 0.92-0.95) and 0.899 (95% CI: 0.86-0.93), respectively (p=0.02). These measures were 0.92 (95% CI: 0.90-0.94) and 0.86 (95% CI: 0.83-0.90), respectively, regarding poor outcome (p=0.001). The optimum cut-off point in predicting outcome was found to be 3 for REMS model and 2 for RAPS model. The sensitivity and specificity of REMS and RAPS in the mentioned cut offs were 95.93 vs. 85.37 and 77.63 vs. 83.51, respectively, in predicting mortality. Calibration and overall performance of the two models were acceptable. Conclusion: The present study showed that adding age and level of arterial oxygen saturation to the variables included in RAPS model can increase its predictive value. Therefore, it seems that REMS could be used for predicting mortality and poor outcome of trauma patients in emergency settings. PMID:28286837

  5. Emerging diseases and ecosystem instability: new threats to public health.

    PubMed Central

    Epstein, P R

    1995-01-01

    Ecologists have begun to describe an environmental distress syndrome, whereby widespread loss of top predators and harsh environmental conditions are encouraging the selection of opportunistic pests and pathogens across a wide taxonomic range of plants and animals. Environmental change and pollutants stress individuals and populations, and this may be reflected in the global resurgence of infectious disease as these stresses cascade through the community assemblages of species. In 1993, the sudden appearance of a virulent, rodent-borne hantavirus in the arid US Southwest accompanied anomalous weather patterns, and a novel Vibrio cholerae variant (O139 Bengal) emerged in Asia where marine ecosystems are experiencing a pandemic of coastal algal blooms, apparently harboring and amplifying the agent. This paper suggests a framework for integrating the surveillance of health outcomes and key reservoir and vector species, with ecological and climatic monitoring. PMID:7856775

  6. Childhood constipation as an emerging public health problem

    PubMed Central

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-01-01

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities. PMID:27570423

  7. Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia.

    PubMed

    Hassali, Mohamed Azmi; Saleem, Fahad; Shafie, Asrul Akmal; Al-Qazaz, Harith Khalid; Farooqui, Maryam; Aljadhey, Hisham; Atif, Muhammad; Masood, Imran

    2012-11-01

    The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines.

  8. Quantifying Federal Funding and Scholarly Output Related to the Academic Emergency Medicine Consensus Conferences

    PubMed Central

    Nishijima, Daniel K.; Dinh, Tu; May, Larissa; Yadav, Kabir; Gaddis, Gary M.; Cone, David C.

    2014-01-01

    Purpose Since 2000, Academic Emergency Medicine (AEM), the journal of the Society for Academic Emergency Medicine, has presented a one-day consensus conference to generate a research agenda for advancement of a scientific topic. One of the 12 annual issues of AEM is reserved for the proceedings of these conferences. The purpose of this study was to measure academic productivity of these conferences by evaluating subsequent federal research funding received by authors of conference manuscripts and calculating citation counts of conference papers. Method This was a cross-sectional study conducted during August and September 2012. NIH RePORTER was searched to identify subsequent federal funding obtained by authors of the consensus conference issues from 2000 to 2010. Funded projects were coded as related or unrelated to conference topic. Citation counts for all conference manuscripts were quantified using Scopus and Google Scholar. Simple descriptive statistics were reported. Results 852 individual authors contributed to 280 papers published in the 11 consensus conference issues. 137 authors (16%) obtained funding for 318 projects. A median of 22 topic-related projects per conference (range 10–97 projects) accounted for a median of $20,488,331 per conference (range $7,779,512–122,918,205). The average (±SD) number of citations per paper was 15.7 ±20.5 in Scopus and 23.7 ±32.6 in Google Scholar. Conclusions The authors of consensus conference manuscripts obtained significant federal grant support for follow-up research related to conference themes. In addition, the manuscripts generated by these conferences were frequently cited. Conferences devoted to research agenda development appear to be an academically worthwhile endeavor. PMID:24280853

  9. Emergency medicine residents’ attitudes and opinions of in-training exam preparation

    PubMed Central

    Eastin, Travis R; Bernard, Aaron W

    2013-01-01

    Purpose Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation efforts. Methods Second- and third-year EM residents at a single institution were interviewed using a semi-structured format. Qualitative methodology was used to analyze the data. Results Thirteen EM residents participated in the study. Eight major themes and 18 sub-themes were identified. These were further characterized as relating to the exam itself or to exam preparation. Residents generally value the in-training exam. Sixty-nine percent noted that it provided an assessment of their current knowledge and deficiencies. Thirty-eight percent noted that it improved familiarity with the qualifying exam. Regarding exam preparation, residents stated that a question format was preferred, especially when accompanying explanations were of high quality. Additionally, practical considerations, such as portability, impacted resident selection of study tools. Conclusion Residents value the in-training exam as a marker of their academic progress and for their ability to gain familiarity with the qualifying exam. They prefer question-based preparation over text-based learning, as long as there is a detailed explanation of each answer. Educators creating structured in-training review may want to focus on question-based material with detailed explanations. PMID:24062620

  10. Focus on the emerging new fields of network physiology and network medicine

    NASA Astrophysics Data System (ADS)

    Ivanov, Plamen Ch; Liu, Kang K. L.; Bartsch, Ronny P.

    2016-10-01

    Despite the vast progress and achievements in systems biology and integrative physiology in the last decades, there is still a significant gap in understanding the mechanisms through which (i) genomic, proteomic and metabolic factors and signaling pathways impact vertical processes across cells, tissues and organs leading to the expression of different disease phenotypes and influence the functional and clinical associations between diseases, and (ii) how diverse physiological systems and organs coordinate their functions over a broad range of space and time scales and horizontally integrate to generate distinct physiologic states at the organism level. Two emerging fields, network medicine and network physiology, aim to address these fundamental questions. Novel concepts and approaches derived from recent advances in network theory, coupled dynamical systems, statistical and computational physics show promise to provide new insights into the complexity of physiological structure and function in health and disease, bridging the genetic and sub-cellular level with inter-cellular interactions and communications among integrated organ systems and sub-systems. These advances form first building blocks in the methodological formalism and theoretical framework necessary to address fundamental problems and challenges in physiology and medicine. This ‘focus on’ issue contains 26 articles representing state-of-the-art contributions covering diverse systems from the sub-cellular to the organism level where physicists have key role in laying the foundations of these new fields.

  11. Antiviral therapies against Ebola and other emerging viral diseases using existing medicines that block virus entry

    PubMed Central

    Long, Jason; Wright, Edward; Molesti, Eleonora; Temperton, Nigel; Barclay, Wendy

    2015-01-01

    Emerging viral diseases pose a threat to the global population as intervention strategies are mainly limited to basic containment due to the lack of efficacious and approved vaccines and antiviral drugs. The former was the only available intervention when the current unprecedented Ebolavirus (EBOV) outbreak in West Africa began. Prior to this, the development of EBOV vaccines and anti-viral therapies required time and resources that were not available. Therefore, focus has turned to re-purposing of existing, licenced medicines that may limit the morbidity and mortality rates of EBOV and could be used immediately. Here we test three such medicines and measure their ability to inhibit pseudotype viruses (PVs) of two EBOV species, Marburg virus (MARV) and avian influenza H5 (FLU-H5). We confirm the ability of chloroquine (CQ) to inhibit viral entry in a pH specific manner. The commonly used proton pump inhibitors, Omeprazole and Esomeprazole were also able to inhibit entry of all PVs tested but at higher drug concentrations than may be achieved in vivo. We propose CQ as a priority candidate to consider for treatment of EBOV. PMID:26069727

  12. An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness

    PubMed Central

    Trent, Shane; Wickizer, Stephen

    2016-01-01

    Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy’s (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts. PMID:27073273

  13. Kidney bioengineering in regenerative medicine: An emerging therapy for kidney disease.

    PubMed

    Lin, Yi-Qian; Wang, Li-Ren; Pan, Liang-Liang; Wang, Hui; Zhu, Gui-Qi; Liu, Wen-Yue; Wang, Jiang-Tao; Braddock, Martin; Zheng, Ming-Hua

    2016-02-01

    The prevalence of end-stage renal disease is emerging as a serious worldwide public health problem because of the shortage of donor organs and the need to take lifelong immunosuppressive medication in patients who receive a transplanted kidney. Recently, tissue bioengineering of decellularization and recellularization scaffolds has emerged as a novel strategy for organ regeneration, and we review the critical technologies supporting these methods. We present a summary of factors associated with experimental protocols that may shed light on the future development of kidney bioengineering and we discuss the cell sources and bioreactor techniques applied to the recellularization process. Finally, we review some artificial renal engineering technologies and their future prospects, such as kidney on a chip and the application of three-dimensional and four-dimensional printing in kidney tissue engineering.

  14. Building better connections: the National Library of Medicine and public health

    PubMed Central

    Humphreys, Betsy L.

    2007-01-01

    Purpose: The paper describes the expansion of the public health programs and services of the National Library of Medicine (NLM) in the 1990s and provides the context in which NLM's public health outreach programs arose and exist today. Brief Description: Although NLM has always had collections and services relevant to public health, the US public health workforce made relatively little use of the library's information services and programs in the twentieth century. In the 1990s, intensified emphases on outreach to health professionals, building national information infrastructure, and promoting health data standards provided NLM with new opportunities to reach the public health community. A seminal conference cosponsored by NLM in 1995 produced an agenda for improving public health access to and use of advanced information technology and electronic information services. NLM actively pursued this agenda by developing new services and outreach programs and promoting public health informatics initiatives. Method: Historical analysis is presented. Results/Outcome: NLM took advantage of a propitious environment to increase visibility and understanding of public health information challenges and opportunities. The library helped create partnerships that produced new information services, outreach initiatives, informatics innovations, and health data policies that benefit the public health workforce and the diverse populations it serves. PMID:17641764

  15. Public Health Emergencies of International Concern: Global, Regional, and Local Responses to Risk.

    PubMed

    Bennett, Belinda; Carney, Terry

    2017-03-31

    The declaration in 2009 that the H1N1 pandemic constituted a public health emergency of international concern (PHEIC) was the first such declaration under the revised International Health Regulations that were adopted in 2005. In the period since then PHEIC have been declared in relation to polio, Ebola, and Zika. This article evaluates initiatives that have been introduced globally, within the Asia-Pacific region, and within Australia, to strengthen preparedness for public health emergencies. Through analysis of evolving conceptualisations of risk, surveillance of zoonotic diseases, and development of public health capacities, the article argues that to date the global community has failed to make the necessary investments in health system strengthening, and that without these investments, global public health emergencies will continue to be an ongoing challenge.

  16. Emerging zoonoses and pathogens of public health significance--an overview.

    PubMed

    Brown, C

    2004-08-01

    Emerging zoonotic diseases have assumed increasing importance in public and animal health, as the last few years have seen a steady stream of new diseases, each emerging from an unsuspected quarter and causing severe problems for animals and humans. The reasons for disease emergence are multiple, but there are two main factors--expansion of the human population and globalisation of trade. Current issues such as the increasing movement of a variety of animal species, ecological disruption, uncultivatable organisms, and terrorism, all imply that emerging zoonotic diseases will in all probability, not only continue to occur, but will increase in the rate of their emergence. The recurring nature of the crises dictates that closer integration of veterinary and medical communities is warranted, along with improved education of the general public and policy makers.

  17. Implications of the Emergency Medical Treatment and Labor Act (EMTALA) during public health emergencies and on alternate sites of care.

    PubMed

    Roszak, Andrew R; Jensen, Frances R; Wild, Richard E; Yeskey, Kevin; Handrigan, Michael T

    2009-12-01

    Hospitals throughout the country are using innovative strategies to accommodate the surge of patients brought on by the novel H1N1 virus. One strategy has been to help decompress the amount of patients seeking care within emergency departments by using alternate sites of care, such as tents, parking lots, and community centers as triage, staging, and screening areas. As at any other time an individual presents on hospital property, hospitals and providers must be mindful of the requirements of the Emergency Medical Treatment and Labor Act. In this article we review the act and its implications during public health emergencies, with a particular focus on its implications on alternative sites of care.

  18. [Excessive Internet use and Internet addiction: emerging public health issues.].

    PubMed

    Coniglio, Maria Anna; Muni, Viviana; Giammanco, Giuseppe; Pignato, Sarina

    2007-01-01

    A survey was performed among students of various faculties at the University of Catania (Italy) to examine the health effects of excessive Internet use and behaviour patterns of Internet dependency. Three hundred students were recruited through a non probabilistic quota sampling method and were asked to complete a questionnaire aimed at identifying attitudes and behaviours regarding Internet use, and the psychological and physical consequences of excessive use of the Internet. The most relevant findings that emerged from student responses regard: emotional dependency on the Internet (5% of students believe that Internet facilitates social relationships, 4% experiences euphoric feelings or excitement while on-line, 1% consider the Internet as a way of escaping from real life), the excessive amount of time spent on-line (8%) and the inability to end an on-line session(8%), lying to family members to conceal the nature of involvement with the Internet (3%), giving up sports (2%) or meals (1%), the negative impact on school grades (3%), lack of sleep (4%), and physical health problems such as backache (2%), arm or wrist pain (2%), vision disturbances (6%).

  19. Emerging foodborne diseases: an evolving public health challenge.

    PubMed Central

    Tauxe, R. V.

    1997-01-01

    The epidemiology of foodborne disease is changing. New pathogens have emerged, and some have spread worldwide. Many, including Salmonella, Escherichia coli O157:H7, Campylobacter, and Yersinia enterocolitica, have reservoirs in healthy food animals, from which they spread to an increasing variety of foods. These pathogens cause millions of cases of sporadic illness and chronic complications, as well as large and challenging outbreaks over many states and nations. Improved surveillance that combines rapid subtyping methods, cluster identification, and collaborative epidemiologic investigation can identify and halt large, dispersed outbreaks. Outbreak investigations and case-control studies of sporadic cases can identify sources of infection and guide the development of specific prevention strategies. Better understanding of how pathogens persist in animal reservoirs is also critical to successful long-term prevention. In the past, the central challenge of foodborne disease lay in preventing the contamination of human food with sewage or animal manure. In the future, prevention of foodborne disease will increasingly depend on controlling contamination of feed and water consumed by the animals themselves. PMID:9366593

  20. [Treatment of childhood injuries and violence in public emergency services].

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Denis Medeiros; Neves, Alice Cristina Medeiros das; Silva, Marta Alves da

    2015-05-01

    This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health's system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child's home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

  1. Responding to Public Health Emergencies on Tribal Lands: Jurisdictional Challenges and Practical Solutions.

    PubMed

    Barnard, Justin B

    2015-01-01

    Response to public health emergencies on tribal lands poses a unique challenge for state and tribal public health officials. The complexity and intensely situation-specific nature of federal Indian jurisprudence leaves considerable question as to which government entity, state or tribal, has jurisdiction on tribal lands to undertake basic emergency measures such as closure of public spaces, quarantine, compulsory medical examination, and investigation. That jurisdictional uncertainty, coupled with cultural differences and an often troubled history of tribal-state relations, threatens to significantly impede response to infectious disease outbreaks or other public health emergencies on tribal lands. Given that tribal communities may be disproportionately impacted by public health emergencies, it is critical that tribal, state, and local governments engage with each other in coordinated planning for public health threats. This Article is offered as a catalyst for such planning efforts. The Article identifies some of the most pressing jurisdictional issues that may confront governments responding to a public health emergency on tribal lands, with the aim of highlighting the nature of the problem and the need for action. The Article goes on to examine the most promising means of addressing jurisdictional uncertainty: intergovernmental agreements. Already utilized in many areas of shared interest between tribe and state, intergovernmental agreements offer neighboring state, local, and tribal governments a vehicle for delineating roles and authorities in an emergency, and may lay the groundwork for sharing resources. The Article surveys various representative tribal public health intergovernmental agreements, and concludes with suggestions for tribes and state or local governments looking to craft their own agreements.

  2. Research Publications in Medical Journals (1992-2013) by Family Medicine Authors - Suez Canal University-Egypt

    PubMed Central

    Abdulmajeed, Abdulmajeed A.; Ismail, Mosleh A.; Nour-Eldein, Hebatallah

    2014-01-01

    Background: Research in family medicine (FM) provides an important contribution to its discipline. Family medicine research can contribute to many areas of primary care, ranging from the early diagnosis to equitable health care. Publication productivity is important in academic settings as a marker for career advancement. Objective: To describe the publications by family medicine researcher authors between 1992 and 2013. Materials and Methods: All full text, original articles published by family medicine researcher; author with affiliation to the Suez Canal University were collected using the internet and hand search. The journals that published for family medicine researcher authors were identified. Author characteristics were described. The trend of publications was described. All articles were analyzed for their characteristics, including the themes and study designs according to predefined criteria. Results: Along 22 years, 149 research articles were published by 48 family medicine authors in 39 medical journals. The largest category in publications was related to Family physician/Health service (FP-HS, n = 52 articles), followed by ‘Patient’ category (n = 42). All the studies were quantitative; the largest group was represented by cross-sectional studies (76.5%). Conclusions: The publication productivity by family medicine researchers are going to be increased. FP-HS and patient topics were mostly addressed in publications. Cross-sectional studies exceeded any other designs. There is need to put more emphasis on intervention studies. Continuous assessment and improvement of FM research production and publication is recommended. PMID:25657945

  3. A model of standardized training in basic life support skills of emergency medicine residents.

    PubMed

    Cimrin, Arif H; Topacoglu, Hakan; Karcioglu, Ozgur; Ozsarac, Murat; Ayrik, Cuneyt

    2005-01-01

    This intervention study was designed to determine the current level of basic life support knowledge and skills of residents in a university-based emergency medicine residency program, and to investigate the potential benefit derived by these residents from a standardized theoretical and practical training session. All residents underwent tests before and after the training session. The residents were asked to perform basic life support on a recording cardiopulmonary resuscitation mannequin. Assessments were made using a 10-item checklist, with the highest score being 17. Each step performed by the resident was scored by an emergency physician for accuracy and effectiveness. Twenty-eight residents participated in the study. According to the modified Berden scale, the pretest and posttest scores were 11.2 +/- 2.9 and 15.6 +/- 1.0, respectively, and the mean difference was 4.36 +/- 2.9 (t test, P<.001). Only 11 residents (39.3%) were rated as "good" or "very good" in the pretest, whereas the corresponding figure in the posttest was 27 (96.4%) (P<.001). Skills, such as checking the airway patency (P<.001), checking breathing (P<.001), appropriate compression rate (P<.003), and delivering 2 effective breaths (P<.001), improved significantly. Depth of chest compression (P<.023) was improved significantly only in residents with fewer than 2 years of experience. The training process should comprise standardized courses to facilitate acquisition of the desired skills.

  4. Cancer: an emergent property of disturbed resource-rich environments? Ecology meets personalized medicine.

    PubMed

    Ducasse, Hugo; Arnal, Audrey; Vittecoq, Marion; Daoust, Simon P; Ujvari, Beata; Jacqueline, Camille; Tissot, Tazzio; Ewald, Paul; Gatenby, Robert A; King, Kayla C; Bonhomme, François; Brodeur, Jacques; Renaud, François; Solary, Eric; Roche, Benjamin; Thomas, Frédéric

    2015-07-01

    For an increasing number of biologists, cancer is viewed as a dynamic system governed by evolutionary and ecological principles. Throughout most of human history, cancer was an uncommon cause of death and it is generally accepted that common components of modern culture, including increased physiological stresses and caloric intake, favor cancer development. However, the precise mechanisms for this linkage are not well understood. Here, we examine the roles of ecological and physiological disturbances and resource availability on the emergence of cancer in multicellular organisms. We argue that proliferation of 'profiteering phenotypes' is often an emergent property of disturbed, resource-rich environments at all scales of biological organization. We review the evidence for this phenomenon, explore it within the context of malignancy, and discuss how this ecological framework may offer a theoretical background for novel strategies of cancer prevention. This work provides a compelling argument that the traditional separation between medicine and evolutionary ecology remains a fundamental limitation that needs to be overcome if complex processes, such as oncogenesis, are to be completely understood.

  5. Cancer: an emergent property of disturbed resource-rich environments? Ecology meets personalized medicine

    PubMed Central

    Ducasse, Hugo; Arnal, Audrey; Vittecoq, Marion; Daoust, Simon P; Ujvari, Beata; Jacqueline, Camille; Tissot, Tazzio; Ewald, Paul; Gatenby, Robert A; King, Kayla C; Bonhomme, François; Brodeur, Jacques; Renaud, François; Solary, Eric; Roche, Benjamin; Thomas, Frédéric

    2015-01-01

    For an increasing number of biologists, cancer is viewed as a dynamic system governed by evolutionary and ecological principles. Throughout most of human history, cancer was an uncommon cause of death and it is generally accepted that common components of modern culture, including increased physiological stresses and caloric intake, favor cancer development. However, the precise mechanisms for this linkage are not well understood. Here, we examine the roles of ecological and physiological disturbances and resource availability on the emergence of cancer in multicellular organisms. We argue that proliferation of ‘profiteering phenotypes’ is often an emergent property of disturbed, resource-rich environments at all scales of biological organization. We review the evidence for this phenomenon, explore it within the context of malignancy, and discuss how this ecological framework may offer a theoretical background for novel strategies of cancer prevention. This work provides a compelling argument that the traditional separation between medicine and evolutionary ecology remains a fundamental limitation that needs to be overcome if complex processes, such as oncogenesis, are to be completely understood. PMID:26136819

  6. Bridging the gap between clinical research and knowledge translation in pediatric emergency medicine.

    PubMed

    Hartling, Lisa; Scott-Findlay, Shannon; Johnson, David; Osmond, Martin; Plint, Amy; Grimshaw, Jeremy; Klassen, Terry P

    2007-11-01

    In 2006, a multidisciplinary group of researchers from across Canada submitted a successful application to the Canadian Institutes for Health Research for a Canadian Institutes for Health Research Team in Pediatric Emergency Medicine. The conceptual foundation for the proposal was to bring together two areas deemed critical for optimizing health outcomes: clinical research and knowledge translation (KT). The framework for the proposed work is an iterative figure-eight model that provides logical steps for research and a seamless flow between the development and evaluation of therapeutic interventions (clinical research) and the implementation and uptake of those interventions that prove to be effective (KT). Under the team grant, we will conduct seven distinct projects relating to the two most common medical problems affecting children in the emergency department: respiratory illness and injury. The projects span the research continuum, with some projects targeting problems for which there is little evidence, while other projects involve problems with a strong evidence base but require further work in the KT realm. In this article, we describe the history of the research team, the research framework, the individual research projects, and the structure of the team, including coordination and administration. We also highlight some of the many advantages of bringing this research program together under the umbrella of a team grant, including opportunities for cross-fertilization of ideas, collaboration among multiple disciplines and centers, training of students and junior researchers, and advancing a methodological research agenda.

  7. Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows

    PubMed Central

    Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

    2016-01-01

    Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people’s perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program’s objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent’s reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient’s parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows’ self-reported comfort level in DBN to a patient/family and dealing with patient and parent

  8. Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows.

    PubMed

    Chumpitazi, Corrie E; Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

    2016-05-01

    Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people's perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program's objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent's reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient's parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows' self-reported comfort level in DBN to a patient/family and dealing with patient and parent emotions

  9. Emergency medicine in Paarl, South Africa: a cross-sectional descriptive study

    PubMed Central

    Hanewinckel, Rens; Wallis, Lee A.; Mulligan, Terrence M.

    2010-01-01

    Background Emergency Medicine (EM) in South Africa is in its earliest stages of development. There is a paucity of data about emergency department (ED) patient demographics, epidemiology, consultation and admission criteria and other characteristics. Aims This information is absolutely necessary to properly guide the development of EM and appropriate emergency care systems. In order to provide this information, we performed a study in a rural hospital in Paarl, 60 km outside Cape Town. Methods All patients who were seen in the ED between 1 January 2008 and 31 May 2008 were eligible for our research. We designed a cross-sectional descriptive study and retrieved information from a randomized sample of all consecutive patient charts seen during this period using a 40-point questionnaire (see Appendix 1). Results We investigated 2,446 charts, of which 2,134 were suitable for our research The majority (88.2%) of these patients were self-referred. In our sample, 24.1% were children under 12 years old. Almost 20% of patients had a serious pathological condition or were physiologically unstable; 36.0% of all presentations were trauma related. Besides trauma-related problems, gastrointestinal- (21.9%) and respiratory tract- (12.4%) related problems were most common in the ED; 16.5% of the patients were admitted to a ward. Conclusion This descriptive epidemiological study provides necessary data that will be used for further needs assessments and for future EM development in Paarl, and can be used as a template in other EDs and hospitals to provide similar data necessary for initial EM development strategy. PMID:21031037

  10. Adverse Drug Reactions in a Tertiary Care Emergency Medicine Ward - Prevalence, Preventability and Reporting

    PubMed Central

    Rydberg, Diana M.; Holm, Lennart; Engqvist, Ida; Fryckstedt, Jessica; Lindh, Jonatan D.; Stiller, Carl-Olav; Asker-Hagelberg, Charlotte

    2016-01-01

    Purpose To identify the prevalence and preventability of adverse drug reactions (ADRs) in an emergency ward setting in a tertiary hospital in Sweden and to what extent the detected ADRs were reported to the Medical Product Agency (MPA). Methods In this prospective cross sectional observational study, 706 patients admitted to one of the Emergency Wards, at the Karolinska University Hospital in Solna, Stockholm during September 2008 –September 2009, were included. The electronic patient records were reviewed for patients’ demographic parameters, prevalence of possible ADRs and assessment of their preventability. In addition, the extent of formal and required ADR reporting to national registers was studied. Results Approximately 40 percent of the patient population had at least one possible ADR (n = 284). In the multivariable regression model, age and number of drugs were significantly associated with risk of presenting with an ADR (p<0.01 and p<0.001, respectively). Sex was not identified as a significant predictor of ADRs (p = 0.27). The most common ADRs were cardiovascular, followed by electrolyte disturbances, and hemorrhage. In 18 percent of the patient population ADRs were the reason for admission or had contributed to admission and 24% of these ADRs were assessed as preventable. The under-reporting of ADRs to the MPA was 99%. Conclusions ADRs are common in Emergency Medicine in tertiary care in Sweden, but under-reporting of ADRs is substantial. The most frequent ADRs are caused by cardiovascular drugs, and significantly associated with age and number of drugs. However, only a minority of the detected serious ADRs contributing to admission could have been avoided by increased risk awareness. PMID:27622270

  11. Cancer among circumpolar populations: an emerging public health concern

    PubMed Central

    Young, T. Kue; Kelly, Janet J.; Friborg, Jeppe; Soininen, Leena; Wong, Kai O.

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups – Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the “world average” rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000–2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a “Circumpolar Inuit” group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer. PMID:26765259

  12. Cancer among circumpolar populations: an emerging public health concern.

    PubMed

    Young, T Kue; Kelly, Janet J; Friborg, Jeppe; Soininen, Leena; Wong, Kai O

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups - Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the "world average" rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000-2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a "Circumpolar Inuit" group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.

  13. Use of Social Media During Public Emergencies by People with Disabilities

    PubMed Central

    Morris, John T.; Mueller, James L.; Jones, Michael L.

    2014-01-01

    Introduction: People with disabilities are generally more vulnerable during disasters and public emergencies than the general population. Physical, sensory and cognitive impairments may result in greater difficulty in receiving and understanding emergency alert information, and greater difficulty in taking appropriate action. The use of social media in the United States has grown considerably in recent years. This has generated increasing interest on the part of national, state and local jurisdictions in leveraging these channels to communicate public health and safety information. How and to what extent people with disabilities use social and other communications media during public emergencies can help public safety organizations understand the communication needs of the citizens in their jurisdictions, and plan their social media and other communications strategies accordingly. Methods: This article presents data from a survey on the use of social media and other communications media during public emergencies by people with disabilities conducted from November 1, 2012 through March 30, 2013. Results: The data presented here show four key results. First, levels of use of social media in general are high for people with disabilities, as well as for the general population. Second, use of social media during emergencies is still low for both groups. Third, levels of use of social media are not associated with income levels, but are significantly and strongly associated with age: younger people use social media at higher rates than older people in both groups (p<0.001). Fourth, differences in the use of social media during emergencies across disability types are slight, with the exception of deaf and hard-of-hearing respondents, the former more likely to have used social media to receive (p=0.002), verify (p=0.092) and share (p=0.007) emergency information. Conclusion: These last two results suggest that effective emergency communications strategies need to rely on

  14. [The Publication of Hyangyakjipseongbang and the Chosŏnization of the Chinese medicine].

    PubMed

    Lee, Kyung-Lock

    2011-12-31

    This article explores the Hyangyakjipseongbang, which was published in 1433, in view of the Chosŏnization of the Chinese medicine. This study discusses the structure of combination between the Chosŏn medicine and the Chinese medicine by analyzing the process of publication, the transmission of the Korean traditional medical books, the diseases and the prescriptions of Hyangyakjipseongbang. Most prescriptions of Hyangyakjipseongbang had been collected from the Chinese medical books. And the editors of Hyangyakjipseongbang, Chosŏn medical scientists, made an intensive investigation into the Chinese medicine and reconciled the official names of the Hyangyak(Korean traditional herbs) with the Chinese herbs. With the acception of the Chinese disease system including gynecology and pediatrics, Hyangyakjipseongbang was similar to the Chinese medical books such as Seonghyebang and Seongjechongrok. So Hyangyakjipseongbang became a general medical book which aimed to treat all kind of the East Asian diseases with the Hyangyak. However Hyangyakjipseongbang was one of the famous Chosŏn medical books. This book was regarded as the revised edition of Hyangyakjesaengjipseongbang, which was published in 1399. The list of chapters, formation of texts of Hyangyakjipseongbang and Hyangyakjesaengjipseongbang were much alike, besides some sentences of two books were coincided. An important point is that new diseases were created with the Publication of Hyangyakjipseongbang. Various symptoms like jaundice and nonstop runny nose of the Chinese medicine were recognized as the diseases in Chosŏn, and the proper treatments should be needed. Even though the formation of Hyangyakjipseongbang complied with that of the Chinese medical books on the whole, Chosŏn medical scientists chosen the prescriptions and decided the chapter order. And some diseases of Hyangyakjipseongbang were related with the infectious diseases and diabetes which were rampant in the late Kory period and the early

  15. The Opportunities of Crises and Emergency Risk Communication in Activities of Serbian Public Health Workforce in Emergencies

    PubMed Central

    Radović, V; Ćurčić, L

    2012-01-01

    Background: The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. Methods: We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. Results: The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Conclusion: Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities. PMID:23308348

  16. Major emerging vector-borne zoonotic diseases of public health importance in Canada.

    PubMed

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-06-10

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

  17. Major emerging vector-borne zoonotic diseases of public health importance in Canada

    PubMed Central

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-01-01

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response. PMID:26954882

  18. [Medical decision in a very elderly patient: a case report of application of the Leonetti law in emergency medicine].

    PubMed

    Burnod, A; Choquet, C; Houissa, H; Danis, J; Pellenc, Q; Duchateau, F X

    2014-05-01

    Advanced care decision in emergency medicine is difficult for the elderly. How to be fair, avoiding an unreasonable obstinacy? Based on the case of very old person, we show how an optimal management can be decided in accordance with the spirit of the law.

  19. The Puerto Rico Journal of Public Health and Tropical Medicine (1925-1950): From a Health Department Bulletin to a UPR School of Tropical Medicine Scientific Journal.

    PubMed

    Mayo-Santana, Raúl

    2016-12-01

    This essay presents a history of the scientific journal of the University of Puerto Rico, School of Tropical Medicine (STM) under the auspices of Columbia University: The Puerto Rico Journal of Public Health and Tropical Medicine. This is the third article in a historical series about the STM, and includes supporting information relevant to the forthcoming articles on the school's scientific endeavors. This article is conceived as a history from the perspective of the literature of journal genre in the field of tropical medicine. The STM scientific journal, precursor of the Puerto Rico Health Sciences Journal, had five main stages. First (1925-1927), originated as an official bulletin of the Health Department (Porto Rico Health Review). Second (1927-1929), became a project of mutual collaboration between the Health Department and the STM, and the publication's title reflected the fields of public health and tropical medicine. Third (1929-1932), acquired a scientific focus as it changed to a quarterly science publication. Fourth (1932-1942), became a fully bilingual journal and acquired its definitive name. Fifth (1942-1950), the final phase in which the first Puerto Rican Director became the principal editor until the Journal's dissolution. The analysis of authorship and the content analysis of the topics of diseases, public health and basic sciences, clarify the history of tropical medicine during the first half of the 20th century in Puerto Rico. The article highlights major symbolic events that delve into the understanding of a collaborative exemplar of the modernity of medical science.

  20. The role of the Faculty of Public Health (Medicine) in developing a multidisciplinary public health profession in the UK.

    PubMed

    Griffiths, Sian; Crown, June; McEwen, Jim

    2007-06-01

    The Faculty of Public Health (FPH) started out its life as the Faculty of Community Medicine. Its initial membership was drawn from the ranks of Medical Officers of Health (MOsH), medical administrators and consultants working in communicable disease. Born under the aegis of the three Royal Colleges of Physicians, it was de facto for members of the medical profession. This was despite the intention of some of the prime movers in its creation that its membership should reflect the multidisciplinary nature of specialist public health. As such, whilst the Faculty's establishment was indeed a triumph, the triumph was only partial, since many senior public health professionals were precluded from full membership. Over the years this situation has changed, but the road to the Faculty's current open policy, based on achieving public health excellence rather than holding a professional badge, has not been a smooth one. The fears of many medical members that the specialty would be down graded through opening up its membership posed successive presidents with many, often justifiable, challenges. In this article we, former presidents, reflect on the key events during our successive tenures.

  1. Public library consumer health information pilot project: results of a National Library of Medicine evaluation.

    PubMed

    Wood, F B; Lyon, B; Schell, M B; Kitendaugh, P; Cid, V H; Siegel, E R

    2000-10-01

    In October 1998, the National Library of Medicine (NLM) launched a pilot project to learn about the role of public libraries in providing health information to the public and to generate information that would assist NLM and the National Network of Libraries of Medicine (NN/LM) in learning how best to work with public libraries in the future. Three regional medical libraries (RMLs), eight resource libraries, and forty-one public libraries or library systems from nine states and the District of Columbia were selected for participation. The pilot project included an evaluation component that was carried out in parallel with project implementation. The evaluation ran through September 1999. The results of the evaluation indicated that participating public librarians were enthusiastic about the training and information materials provided as part of the project and that many public libraries used the materials and conducted their own outreach to local communities and groups. Most libraries applied the modest funds to purchase additional Internet-accessible computers and/or upgrade their health-reference materials. However, few of the participating public libraries had health information centers (although health information was perceived as a top-ten or top-five topic of interest to patrons). Also, the project generated only minimal usage of NLM's consumer health database, known as MEDLINEplus, from the premises of the monitored libraries (patron usage from home or office locations was not tracked). The evaluation results suggested a balanced follow-up by NLM and the NN/LM, with a few carefully selected national activities, complemented by a package of targeted activities that, as of January 2000, are being planned, developed, or implemented. The results also highlighted the importance of building an evaluation component into projects like this one from the outset, to assure that objectives were met and that evaluative information was available on a timely basis, as was

  2. Funding mechanisms for gender-specific research: proceedings from a panel discussion at the 2014 Academic Emergency Medicine consensus conference.

    PubMed

    Safdar, Basmah; Greenberg, Marna R; Anise, Ayodola; Brown, Jeremy; Conwit, Robin; Filart, Rosemarie; Scott, Jane; Choo, Esther K

    2014-12-01

    As part of the 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," we assembled a diverse panel of representatives from federal and nonfederal funding agencies to discuss future opportunities for sex- and gender-specific research. The discussion revolved around the mission and priorities of each organization, as well as its interest in promoting sex- and gender-specific research. The panelists were asked to provide specific examples of funding lines generated or planned for as pertinent to emergency care. Training opportunities for future researchers in this area were also discussed.

  3. Implementing emergency research requiring exception from informed consent, community consultation, and public disclosure.

    PubMed

    Salzman, Joshua G; Frascone, Ralph J; Godding, Bobette K; Provo, Terry A; Gertner, Elie

    2007-10-01

    Conducting emergency research in the out-of-hospital and emergency department setting is a challenge because of the inability of patients to provide informed consent in many situations. Federal guidelines allowing research under an exception from informed consent for emergency research have been established (21 CRF 50.24). Community consultation and public disclosure, 2 required components of obtaining this exception, are seen by many as a barrier to resuscitation research. This article will provide a brief overview of the history of the exception from informed consent for emergency research and summarize our methods recently used to successfully complete community consultation and public disclosure for a trial evaluating 2 devices used during cardiopulmonary resuscitation in a large metropolitan area.

  4. How to anticipate the assessment of the public health benefit of new medicines?

    PubMed

    Massol, Jacques; Puech, Alain; Boissel, Jean-Pierre

    2007-01-01

    The Public Health Benefit (PHB) of new medicines is a recent and French-specific criterion (October 1999 decree) which is often only partially documented in the transparency files due to a lack of timely information. At the time of the first reimbursement application for a new medicine to the "Transparency Committee", the file is exclusively based on data from randomised clinical trials. These data are generated from a global clinical development plan which was designed a long time before the new medicine's submission for reimbursement. And this plan does not systematically provide the data needed to assess the PHB. Thus, one easily understands the difficulty to anticipate and document this recent French criterion. In France, the PHB is both one of the necessary criteria for the reimbursement submission and an indicator for the national health policy management. Its assessment also helps to identify the needs and objectives of the post-registration studies (nowadays in the scope of responsibilities of the "Drug Economics Committee"). The assessment of the PHB criterion is carried through after the marketing authorization process and is an addition to it. To understand how to anticipate the assessment of the new medicines' PHB, one needs to consider how it differs from the preliminary step of the marketing authorization process. Whereas the evaluation for marketing authorization seeks to determine if the new medicine could be useful in a specific indication, the PHB assessment aims at quantifying the therapeutic benefit in a population, taking into account the reference treatments in this population. A new medicine receives a marketing authorization based on the data of the registration file which provides information on the clinical benefit of the new medicine in the populations of the trials and in the context of the trials. On the other side, the PHB looks at the effects of the new medicine at the scale of the general population, in real practice. The PHB

  5. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

    PubMed Central

    Bellolio, M. Fernanda; Cabrera, Daniel; Sadosty, Annie T.; Hess, Erik P.; Campbell, Ronna L.; Lohse, Christine M.; Sunga, Karmen L.

    2014-01-01

    Introduction Compassion fatigue (CF) is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM) resident physicians, including an assessment of contributing factors. Methods We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress), with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013), or did not work overnight (mean score 23.5 vs 21.3; p=0.022). EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048), and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012). Conclusion CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily night shifts and

  6. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role

    PubMed Central

    HOSEIN NEJAD, HOOMAN; BAGHERABADI, MEHDI; SISTANI, ALIREZA; DARGAHI, HELEN

    2017-01-01

    Introduction: Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents’ teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students’ perception of the residents’ teaching quality. Methods: This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick’s model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents’ teaching skills based on their self-evaluation and Mann-Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop. Results: The results indicated that residents’ attitude towards their teaching ability was improved significantly after participating in the workshop (p<0.001). The result of residents’ evaluation by interns showed no significant difference before and after the workshop (p=0.07). Conclusion: On the whole, the educational workshop for Residents as Teacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick’s model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of

  7. Social media responses to the Annals of Emergency Medicine residents' perspective article on multiple mini-interviews.

    PubMed

    Joshi, Nikita K; Yarris, Lalena M; Doty, Christopher I; Lin, Michelle

    2014-09-01

    In May 2014, Annals of Emergency Medicine continued a successful collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM) to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Does the Multiple Mini-Interview Address Stakeholder Needs? An Applicant's Perspective" by Phillips and Garmel. This dialogue included Twitter conversations, a live videocast with the authors and other experts, and detailed discussions on the ALiEM Web site's comment section. This summary article serves the dual purpose of reporting the qualitative thematic analysis from a global online discussion and the Web analytics for our novel multimodal approach. Social media technologies provide a unique opportunity to engage with a diverse audience to detect existing and new emerging themes. Such technologies allow rapid hypothesis generation for future research and enable more accelerated knowledge translation.

  8. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service.

    PubMed

    Mao, Yong; Qin, Zong-He

    2015-01-01

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  9. Linking Public Health and Individual Medicine: The Health Policy Approach of Surgeon General Thomas Parran.

    PubMed

    Sledge, Daniel

    2017-04-01

    Surgeon General Thomas Parran Jr was once viewed as a path-breaking leader, but his legacy is now highly contested. Scholars of national health insurance have viewed Parran as an impediment to government-backed insurance, and revelations about his role in the Tuskegee Study and in the Public Health Service's experiments in Guatemala have cast a shadow over his career. Surgeon General from 1936 to 1948, Parran led the Public Health Service during the development of key features of the modern American health system and was involved in critical debates over the role of the national government in health. I argue that Parran is best understood not as an opponent of insurance but as the proponent of an approach to health policy that sought to link public health and individual medicine. A pragmatic bureaucrat, Parran believed that effective policymaking required compromise with the American Medical Association.

  10. Master's and doctoral theses in family medicine and their publication output, Suez Canal University, Egypt

    PubMed Central

    Nour-Eldein, Hebatallah; Mansour, Nadia M.; Abdulmajeed, Abdulmajeed A.

    2015-01-01

    Background: The completion of a thesis is a significant requirement for both a Master's and a doctorate degree in general practice/family medicine (GP/FM). A postgraduate thesis is a well-planned, time-intensive activity carried out over several years. The quality of the theses can be judged by the proportion of published papers. Objective: This study aimed to describe Master's and doctoral theses in family medicine and their publications between 1982 and 2014. Materials and Methods: GP/FM degree theses were reviewed at the Faculty of Medicine and central Suez Canal libraries. Several characteristics were extracted from each thesis relating to the main researcher, supervisors, themes, and study methods according to predefined criteria. Publications from the theses were described. Results: Over 33 years, 208 theses were completed by 173 GP/FM researchers. The majority of the theses were for Master's degrees (84.1%). Regarding the study design, most of the degree theses were cross-sectional studies (76.9%). The adult population was targeted in 33.7% of research theses. Nonprobability sampling was used in 51%. Rural communities were the setting of research in 43.8%, and primary health center (PHC)-based studies in 59.1%. The “Patient” category exceeded the other categories (28.4%). Publication from theses started in the second decade of research production. Of the degree theses, 21.6% original articles were published. Only 13.3% of articles from theses were published in PubMed-indexed journals. The researcher was first author in 62.2% of published articles. Conclusion: The production of GP/FM theses and their publications are going to increase. Continuous assessment and planning for GP/FM studies are recommended. PMID:25949959

  11. Changes in the trade in native medicinal plants in Brazilian public markets.

    PubMed

    Brandão, Maria das Graças Lins; Cosenza, Gustavo Pereira; Pereira, Flávia Liparini; Vasconcelos, Ariela Silva; Fagg, Christopher William

    2013-08-01

    Plants continue to be an important source of new bioactive substances. Brazil is one of the world's mega-diverse countries, with 20 % of the world's flora. However, the accelerated destruction of botanically rich ecosystems has contributed to a gradual loss of native medicinal species. In previous study, we have observed a fast and intensive change in trade of medicinal plants in an area of Amazon, where human occupation took place. In this study, we surveyed 15 public markets in different parts of Brazil in search of samples of 40 plants used in traditional medicine and present in first edition of Brazilian Official Pharmacopoeia (FBRAS), published in 1926. Samples of plants commercialized as the same vernacular name as in Pharmacopoeia were acquired and submitted to analysis for authentication. A total of 252 plant samples were purchased, but the laboratory analyses showed that only one-half of the samples (126, 50.2 %) were confirmed as the same plant species so named in FBRAS. The high number of unauthenticated samples demonstrates a loss of knowledge of the original native species. The proximity of the market from areas in which the plant occurs does not guarantee that trade of false samples occurs. The impact of the commerce of the substitute species on their conservation and in public health is worrying. Strategies are necessary to promote the better use and conservation of this rich heritage offered by Brazilian biodiversity.

  12. Preparing for the usual, preparing for the unusual: ethics in routine and emergency public health practice.

    PubMed

    Etkind, Paul; Arias, Donna; Bagley, Bobbie; Nelson, Mary S

    2008-01-01

    A tremendous amount of resources is being poured into public health agencies for the purpose of planning to prevent, respond to, and/or recover from all manner of emergencies. As planning and practice drills have progressed, many of the shortcomings of our current public health system are being recognized. Many gray areas, particularly legal and ethical, are coming into focus. There are many questions about whether the standards of medical care and public health practice will necessarily remain constant during emergencies. This article examines whether the same might be true of the ethical standards of public health practice. Will they or should they be the same regardless of whether we are working in "usual" times or "unusual" times?

  13. Description and Productivity of Emergency Medicine Researchers Receiving K23 or K08 Mentored Research Career Development Awards

    PubMed Central

    Nishijima, Daniel K.; Yadav, Kabir; May, Larissa; Kraynov, Liliya; Courtney, D. Mark

    2013-01-01

    Objectives The primary individual research career development awards for emergency medicine (EM) investigators are the K08 and K23 awards. To the best of the authors’ knowledge, postaward productivity of EM K08 and K23 awardees has not been previously described. The objectives were to describe EM researchers who have received K08 or K23 awards and to evaluate their postaward federal funding and publications. Methods This was a cross-sectional study, conducted during January 2012, of clinician-scientists who previously completed EM residency or fellowship programs and have received K08 or K23 awards from National Institutes of Health (NIH) or Agency for Healthcare Research and Quality (AHRQ) between fiscal years 2000 through 2011. Awardees were identified through the NIH reporting tool (NIH RePORTER). Postaward funding was abstracted, including R01-equivalent funding for K awardees who completed their K training by the end of the 2011 fiscal year. Postaward publications (with journal impact factor) were tabulated for all K awardees using PubMed and Journal Citation Reports. An e-mail survey was also conducted during September and October 2012 to describe the awardee characteristics (demographics and research background) of all EM K awardees using REDCap electronic data captures tools. Simple descriptive statistics are reported. Results Sixty-three EM awardees were identified; 24 (38%) were K08 awardees, and 39 (62%) were K23 awardees. Of the 38 (60%) awardees who completed their K training, 16 (42%) obtained subsequent federal funding, with six (16%) obtaining R01 funding (median time from end of K award to R01 award was 4.5 years). Overall, EM awardees published a mean (±SD) of 4.0 (±1.3) manuscripts per year (after the start of their K awards); the mean (±SD) impact factor of the journals in which these manuscripts were published was 4.5 (±5.7). Forty-five (71%) of EM K awardees responded to the survey. Respondents had a median age of 36 years (interquartile

  14. Museum Monsters and Victorious Viruses: Improving Public Understanding of Emerging Biomedical Research

    PubMed Central

    Diamond, Judy; Jee, Benjamin; Matuk, Camilla; McQuillan, Julia; Spiegel, Amy N.; Uttal, David

    2015-01-01

    Although microbes directly impact everyone's health, most people have limited knowledge about them. In this article, we describe a museum and media public education campaign aimed at helping diverse audiences better understand emerging knowledge about microbes and infectious disease. Funded primarily by the Science Education Partnership (SEPA) program of the National Institutes of Health, this campaign involved crosscutting programs designed to extend impacts throughout a broad public audience. PMID:26392634

  15. A PUBLIC HEALTH PERSPECTIVE ON THE U.S. RESPONSE TO THE FUKUSHIMA RADIOLOGICAL EMERGENCY

    PubMed Central

    Whitcomb, Robert C.; Ansari, Armin J.; Buzzell, Jennifer J.; McCurley, M. Carol; Miller, Charles W.; Smith, James M.; Evans, D. Lynn

    2015-01-01

    On 11 March 2011, northern Japan was struck by first a magnitude 9.0 earthquake off the eastern coast and then by an ensuing tsunami. At the Fukushima Dai-ichi Nuclear Power Plant (NPP), these twin disasters initiated a cascade of events that led to radionuclide releases. Radioactive material from Japan was subsequently transported to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to cause health effects, but the presence of this material in the environment was enough to require a response from the public health community. Events during the response illustrated some U.S. preparedness challenges that previously had been anticipated and others that were newly identified. Some of these challenges include the following: (1) Capacity, including radiation health experts, for monitoring potentially exposed people for radioactive contamination are limited and may not be adequate at the time of a large-scale radiological incident; (2) there is no public health authority to detain people contaminated with radioactive materials; (3) public health and medical capacities for response to radiation emergencies are limited; (4) public health communications regarding radiation emergencies can be improved to enhance public health response; (5) national and international exposure standards for radiation measurements (and units) and protective action guides lack uniformity; (6) access to radiation emergency monitoring data can be limited; and (7) the Strategic National Stockpile may not be currently prepared to meet the public health need for KI in the case of a surge in demand from a large-scale radiation emergency. Members of the public health community can draw on this experience to improve public health preparedness. PMID:25627948

  16. Museum Monsters and Victorious Viruses: Improving Public Understanding of Emerging Biomedical Research.

    PubMed

    Diamond, Judy; Jee, Benjamin; Matuk, Camilla; McQuillan, Julia; Spiegel, Amy N; Uttal, David

    2015-07-01

    Although microbes directly impact everyone's health, most people have limited knowledge about them. In this article, we describe a museum and media public education campaign aimed at helping diverse audiences better understand emerging knowledge about microbes and infectious disease. Funded primarily by the Science Education Partnership (SEPA) program of the National Institutes of Health, this campaign involved crosscutting programs designed to extend impacts throughout a broad public audience.

  17. Age-related geriatric medicine: relevance of special skills of geriatric medicine to elderly people admitted to hospital as medical emergencies.

    PubMed Central

    Kafetz, K; O'Farrell, J; Parry, A; Wijesuriya, V; McElligott, G; Rossiter, B; Lugon, M

    1995-01-01

    This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focused on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care. PMID:8544147

  18. Age-related geriatric medicine: relevance of special skills of geriatric medicine to elderly people admitted to hospital as medical emergencies.

    PubMed

    Kafetz, K; O'Farrell, J; Parry, A; Wijesuriya, V; McElligott, G; Rossiter, B; Lugon, M

    1995-11-01

    This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focused on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care.

  19. Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review

    PubMed Central

    Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Chedi, Basheer A. Z.; Sha’aban, Abubakar; Rahman, Ab Fatah Ab

    2016-01-01

    Many studies have been conducted in health-care settings with regards to complementary and alternative medicine (CAM) use among patients. However, information regarding CAM use among patients in the emergency department (ED) is scarce. The aim of this article was to conduct a systematic review of published studies with regards to CAM use among the ED patients. A literature search of published studies from inception to September 2015 was conducted using PubMed, Scopus, and manual search of the reference list. 18 studies that met the inclusion criteria were reviewed. The prevalence rate of CAM use among ED patients across the studies ranged of 1.4-68.1%. Herbal therapy was the sub-modality of CAM most commonly used and frequently implicated in CAM-related ED visits. Higher education, age, female gender, religious affiliation, and chronic diseases were the most frequent factors associated with CAM use among the ED patients. Over 80% of the ED physicians did not ask the patients about the CAM therapy. Similarly, 80% of the ED patients were ready to disclose CAM therapy to the ED physician. The prevalence rate of CAM use among patients at ED is high and is growing with the current increasing popularity, and it has been a reason for some of the ED visits. There is a need for the health-care professionals to receive training and always ask patients about CAM therapy to enable them provide appropriate medical care and prevent CAM-related adverse events. PMID:27104042

  20. Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review.

    PubMed

    Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Chedi, Basheer A Z; Sha'aban, Abubakar; Rahman, Ab Fatah Ab

    2016-01-01

    Many studies have been conducted in health-care settings with regards to complementary and alternative medicine (CAM) use among patients. However, information regarding CAM use among patients in the emergency department (ED) is scarce. The aim of this article was to conduct a systematic review of published studies with regards to CAM use among the ED patients. A literature search of published studies from inception to September 2015 was conducted using PubMed, Scopus, and manual search of the reference list. 18 studies that met the inclusion criteria were reviewed. The prevalence rate of CAM use among ED patients across the studies ranged of 1.4-68.1%. Herbal therapy was the sub-modality of CAM most commonly used and frequently implicated in CAM-related ED visits. Higher education, age, female gender, religious affiliation, and chronic diseases were the most frequent factors associated with CAM use among the ED patients. Over 80% of the ED physicians did not ask the patients about the CAM therapy. Similarly, 80% of the ED patients were ready to disclose CAM therapy to the ED physician. The prevalence rate of CAM use among patients at ED is high and is growing with the current increasing popularity, and it has been a reason for some of the ED visits. There is a need for the health-care professionals to receive training and always ask patients about CAM therapy to enable them provide appropriate medical care and prevent CAM-related adverse events.

  1. Antifungal properties of crude extracts of five Egyptian medicinal plants against dermatophytes and emerging fungi.

    PubMed

    Hashem, Mohamed

    2011-07-01

    Antifungal properties of the crude extracts of five medicinal plants (Artemisia judaica, Ballota undulate, Cleome amblyocarpa, Peganum harmala, and Teucrium polium) were tested against dermatophytes and emerging fungi. Ethanol extract of Ballota undulate was the most effective against all tested fungi. Paecilomyces lilacinus, P. variotii, and Candida albicans were the most sensitive organisms. The minimum inhibitory concentration (MIC) of Ballota undulate ethanol extract against C. albicans, P. lilacinus, and P. variotii was 25 mg/ml. GC-MS analysis revealed that Ballota undulate ethanol extract contains 35 aliphatic and aromatic hydrocarbons, sesquiterpene hydrocarbon along with some other essential oils, which could be involved in antifungal activity. Light microscopy and scanning electron microscopy (SEM) have proved that Ballota undulate ethanol extract exhibits fungicidal effect on P. lilacinus through alterations in hyphal structures including budding of hyphal tip, anomalous structure, such as swelling, decrease in cytoplasmic content, with clear separation of cytoplasm from cell wall in hyphae. SEM clearly showed distorted mycelium, squashed and flattened conidiophores bearing damaged metullae. Eventually, the mycelia became papillated, flattened, and empty. Puncturing and squashing of hyphae as well as complete cell wall disruption were clear signs of complete death of hyphae.

  2. Simulation in graduate medical education 2008: a review for emergency medicine.

    PubMed

    McLaughlin, Steve; Fitch, Michael T; Goyal, Deepi G; Hayden, Emily; Kauh, Christine Yang; Laack, Torrey A; Nowicki, Thomas; Okuda, Yasuharu; Palm, Ken; Pozner, Charles N; Vozenilek, John; Wang, Ernest; Gordon, James A

    2008-11-01

    Health care simulation includes a variety of educational techniques used to complement actual patient experiences with realistic yet artificial exercises. This field is rapidly growing and is widely used in emergency medicine (EM) graduate medical education (GME) programs. We describe the state of simulation in EM resident education, including its role in learning and assessment. The use of medical simulation in GME is increasing for a number of reasons, including the limitations of the 80-hour resident work week, patient dissatisfaction with being "practiced on," a greater emphasis on patient safety, and the importance of early acquisition of complex clinical skills. Simulation-based assessment (SBA) is advancing to the point where it can revolutionize the way clinical competence is assessed in residency training programs. This article also discusses the design of simulation centers and the resources available for developing simulation programs in graduate EM education. The level of interest in these resources is evident by the numerous national EM organizations with internal working groups focusing on simulation. In the future, the health care system will likely follow the example of the airline industry, nuclear power plants, and the military, making rigorous simulation-based training and evaluation a routine part of education and practice.

  3. Use of Physician Concerns and Patient Complaints as Quality Assurance Markers in Emergency Medicine

    PubMed Central

    Gurley, Kiersten L.; Wolfe, Richard E.; Burstein, Jonathan L.; Edlow, Jonathan A.; Hill, Jason F.; Grossman, Shamai A.

    2016-01-01

    Introduction The value of using patient- and physician-identified quality assurance (QA) issues in emergency medicine remains poorly characterized as a marker for emergency department (ED) QA. The objective of this study was to determine whether evaluation of patient and physician concerns is useful for identifying medical errors resulting in either an adverse event or a near-miss event. Methods We conducted a retrospective, observational cohort study of consecutive patients presenting between January 2008 and December 2014 to an urban, tertiary care academic medical center ED with an electronic error reporting system that allows physicians to identify QA issues for review. In our system, both patient and physician concerns are reviewed by physician evaluators not involved with the patients’ care to determine if a QA issue exists. If a potential QA issue is present, it is referred to a 20-member QA committee of emergency physicians and nurses who make a final determination as to whether or not an error or adverse event occurred. Results We identified 570 concerns within a database of 383,419 ED presentations, of which 33 were patient-generated and 537 were physician-generated. Out of the 570 reports, a preventable adverse event was detected in 3.0% of cases (95% CI = [1.52–4.28]). Further analysis revealed that 9.1% (95% CI = [2–24]) of patient complaints correlated to preventable errors leading to an adverse event. In contrast, 2.6% (95% CI = [2–4]) of QA concerns reported by a physician alone were found to be due to preventable medical errors leading to an adverse event (p=0.069). Near-miss events (errors without adverse outcome) trended towards more accurate reporting by physicians, with medical error found in 12.1% of reported cases (95% CI = [10–15]) versus 9.1% of those reported by patients (95% CI = [2–24] p=0.079). Adverse events in general that were not deemed to be due to preventable medical error were found in 12.1% of patient complaints (95

  4. Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship

    PubMed Central

    Chary, Michael; Leuthauser, Amy; Hu, Kevin; Hexom, Braden

    2017-01-01

    Introduction Medical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for emergency medicine (EM), but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student’s shift in an emergency department and that student’s clerkship performance. Methods The authors conducted a retrospective case series by analyzing the performance and reflective statements of 116 students from a single medical school who participated in a required EM clerkship at one or two of four clinical sites from 2013–14. After each shift, an attending emergency physician evaluated the student according to the RIME (Reporter-Interpreter-Manager-Educator) scheme. The authors developed software to extract the text from those comments, remove uninformative words and standardize the remaining words. The authors determined the most common words and two-word phrases that students used to describe their shift. The correlation between students’ final clerkship grades and the fraction of student comments with at least one content word was analyzed. Results Of the 145 possible students, 116 were included for analysis. The other 29 were excluded as they were visiting students who did not receive a final numeric grade. The correlation between final grade and the number of completed self-reflections was 0.32. The correlation between final grade and the average number of words in each self-reflection was 0.21. The first correlation is significantly greater than 0 (p=0.03, t-test), but the second correlation is not (p=0.16, t-test). The median final grade of those who wrote reflections on more than half of their shifts was significantly greater than those who wrote reflections half of the time, 83.675 versus 79.23 (p=0.05, 2-sample

  5. Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study.

    PubMed

    Hamre, Harald Johan; Kiene, Helmut; Ziegler, Renatus; Tröger, Wilfried; Meinecke, Christoph; Schnürer, Christof; Vögler, Hendrik; Glockmann, Anja; Kienle, Gunver Sophia

    2014-01-01

    Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were

  6. Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study

    PubMed Central

    Kiene, Helmut; Ziegler, Renatus; Tröger, Wilfried; Meinecke, Christoph; Schnürer, Christof; Vögler, Hendrik; Glockmann, Anja; Kienle, Gunver Sophia

    2014-01-01

    Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS incorporated two features proposed for the evaluation of integrative therapy systems: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were

  7. The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.

    PubMed

    Grudzen, Corita R; Anderson, Jana R; Carpenter, Christopher R; Hess, Erik P

    2016-12-01

    Shared decision making in emergency medicine has the potential to improve the quality, safety, and outcomes of emergency department (ED) patients. Given that the ED is the gateway to care for patients with a variety of illnesses and injuries and the safety net for patients otherwise unable to access care, shared decision making in the ED is relevant to numerous disciplines and the interests of the United States (U.S.) public. On May 10, 2016 the 16th annual Academic Emergency Medicine (AEM) consensus conference, "Shared Decision Making: Development of a Policy-Relevant Patient-Centered Research Agenda" was held in New Orleans, Louisiana. During this one-day conference clinicians, researchers, policy-makers, patient and caregiver representatives, funding agency representatives, trainees, and content experts across many areas of medicine interacted to define high priority areas for research in 1 of 6 domains: 1) diagnostic testing; 2) policy, 3) dissemination/implementation and education, 4) development and testing of shared decision making approaches and tools in practice, 5) palliative care and geriatrics, and 6) vulnerable populations and limited health literacy. This manuscript describes the current state of shared decision making in the ED context, provides an overview of the conference planning process, the aims of the conference, the focus of each respective breakout session, the roles of patient and caregiver representatives and an overview of the conference agenda. The results of this conference published in this issue of AEM provide an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.

  8. A nationwide survey of public healthcare providers’ impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments

    PubMed Central

    Cheong, Ai-Theng; Ismail, Mastura; Hamzah, Zuhra; A-Rashid, Mohd-Radzniwan; Md-Yasin, Mazapuspavina; Ali, Norsiah; Mohd-Salleh, Noridah; Bashah, Baizury

    2016-01-01

    Objective To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics. Design Cross-sectional study. Setting This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS). Participants PHCPs from three categories of health facility: hospitals, health clinics and health offices. Main outcome measures Qualitative analyses of written comments of respondents’ general impression of FMSs. Results The participants’ response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices. Conclusions FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation. PMID:26743703

  9. Value-Based Health Care Delivery, Preventive Medicine and the Medicalization of Public Health

    PubMed Central

    2017-01-01

    The real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a ‘value-based health care delivery’. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges. In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of a better healthcare for all, with real benefits for the individual patient provided a tailored and optimized treatment plan suitable for his or her genetic makeup. And maybe, therefore, the assumptions underpinning personalized medicine have largely escaped questioning. The use of personalized medicine and the use of digital technologies is reshaping our health care system and how we think of health interventions and our individual responsibility. However, encouraging individuals to engage in preventive health activities possibly avoids one form of medicalization (clinical), but on the other hand, it takes up another form (preventive medicine and ‘self-care’) that moves medical and health concerns into every corner of everyday life. This ought to be of little value to the individual patient and public health. We ought to instead demand proof of these value ideas and the lacking research. Before this is in place critical appraisal and cynicism are requisite skills for the future. Otherwise, we are just listening to visionaries when we put our future health into their hands and let personalized solutions reach into people's everyday life regardless of patient safety and integrity.

  10. The emergence of pioneering public health education programs in the United States.

    PubMed Central

    Viseltear, A. J.

    1988-01-01

    This paper considers the social forces leading to the establishment of pioneering public health education programs in the United States. Schools of Public Health emerged in the United States as the result of a confluence of factors, including the changing nature of higher education, the development of commerce and industry, the rise to prominence of the science of bacteriology, and the urbanization of the nation, all coupled with a pervasive spirit of utility and a desire to be, in a word, useful. Each line leading to the establishment of five public health institutions at the Massachusetts Institute of Technology, Harvard-M.I.T., Yale, Michigan, and Pennsylvania is explored. PMID:3071923

  11. Turkey’s contribution to medicine: Main institutions, fields and publications

    PubMed Central

    Onat, Altan

    2013-01-01

    Objective: To identify and disclose publications from Turkey with the greatest “genuine” contributons to medicine in the past 50 years. Material and Methods: Based on the data of Web of Science, publications originating from Turkey’s institutions that were received by May, 2013, ≥72 citations were identified, after excluding papers having more than a minor share by international authors. Results: Primary authors numbering 223 generated 271 medical papers, each receiving ≥72 (95% CI 72; 263) citations. The articles cited herein were of a level of top global 8–10% papers. Half of the articles were published in 1997–2004. Compared with about 25–28 papers annually 10 years previously, it is estimated that currently only 20 papers are generated in Turkey annually, representing a global share of only 1.5 per thousand. The rate of rise registered in the period 1995–2004 may be anticipated to attenuate. Internal medicine, led by rheumatology, cardiology and hematology, and neurosciences were represented at 1.8-fold odds higher than the overall average. Led by Behçet’s disease, health issues encountered more widely than in other populations, formed frequent topics of contribution. Led by the Medical Faculties of Istanbul, Hacettepe, Ankara Universities and the Military Medical Academy, only 33 medical faculties and 14 public and private hospitals constituted sources. Conclusion: Since the elicited results are unsatisfactory, compared with Turkey’s potential, much more concerted efforts should be directed to rebuild a milieu favorable to promote research likely to contribute to medicine. PMID:25931859

  12. Eyes wide open: an essay on developing an engaged awareness in global medicine and public health

    PubMed Central

    2014-01-01

    Background There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions. Discussion To address these issues, we share a series of questions we have asked ourselves¿United States¿ citizens with experience living and working in Central America¿in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions. Summary Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health. PMID:25346040

  13. 76 FR 1166 - Office of Consumer Information and Insurance Oversight; Emergency Clearance; Public Information...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-07

    .... PCIP is also referred to as the temporary qualified high risk insurance pool program, as it is called... HUMAN SERVICES Office of Consumer Information and Insurance Oversight; Emergency Clearance; Public... Consumer Information and Insurance Oversight, HHS. In compliance with the requirement of section...

  14. 75 FR 80503 - Emergency Clearance; Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Emergency Clearance; Public Information Collection Requirements Submitted to the Office... Number, and CMS document identifier to Paperwork@cms.hhs.gov , or call the Reports Clearance Office...

  15. 76 FR 19777 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-08

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Emergency Clearance: Public Information... cannot reasonably comply with the normal clearance procedures due to an unexpected event as stated in 5 CFR 1320.13(a)(2)(iii). The use of the normal clearance procedures would cause a statutory deadline...

  16. 78 FR 19357 - Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-29

    ...'s Emergency Relief Program for recovery, relief and resiliency efforts for public transportation in... the affected agencies, excluding projects to improve the resiliency of the affected systems to future... features (resiliency projects). Consistent with FTA's interim final rule, if State or locally adopted...

  17. 76 FR 16789 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... HUMAN SERVICES Centers for Medicare and Medicaid Services Emergency Clearance: Public Information... and Medicaid Services, HHS. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid Services (CMS), Department of...

  18. 76 FR 71038 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... HUMAN SERVICES Centers for Medicare and Medicaid Services Emergency Clearance: Public Information... and Medicaid Services, HHS. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid Services (CMS), Department of...

  19. 78 FR 56898 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-16

    ... HUMAN SERVICES Centers for Medicare and Medicaid Services Emergency Clearance: Public Information... and Medicaid Services, HHS. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid Services (CMS), Department of...

  20. 76 FR 23810 - Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Emergency Response...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... advises interested persons that the FCC Emergency Response Interoperability Center Public Safety Advisory....fullano@fcc.gov (e-mail); or Brian Hurley, Deputy Designated Federal Official for PSAC at (202) 418-2220 (voice) or brian.hurley@fcc.gov (e-mail). SUPPLEMENTARY INFORMATION: The PSAC is a Federal...

  1. 75 FR 70236 - Hop Beta Acids; Receipt of Application for Emergency Exemption, Solicitation of Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... AGENCY Hop Beta Acids; Receipt of Application for Emergency Exemption, Solicitation of Public Comment... Agriculture, and the Oregon Department of Agriculture to use hop beta acids (CAS Reg. No. none specified) to... exemption regional request for use of hop beta acids in honey bee hives to control varroa mites....

  2. Emergency preparedness of families of children with developmental disabilities: What public health and safety emergency planners need to know

    PubMed Central

    Wolf-Fordham, Susan; Curtin, Carol; Maslin, Melissa; Bandini, Linda; Hamad, Charles D.

    2015-01-01

    Objective To assess the emergency preparedness knowledge, behaviors, and training needs of families of children with developmental disabilities (DD). Design An online survey. Participants A sample of 314 self-selecting US parents/guardians of children with DD, aged birth-21 years. Main outcome measures 1) Preparedness self-assessment; 2) self-report regarding the extent to which families followed 11 specific preparedness action steps derived from publicly available preparedness guides; and 3) parent training and support needs. Results Although most participants assessed themselves to be somewhat to moderately well prepared, even those who reported being “very well prepared” had taken fewer than half of 11 recommended action steps. Most participants expressed a need for preparedness support; virtually all the respondents felt that training was either important or very important. Conclusions Children with disabilities are known to be particularly vulnerable to negative disaster impacts. Overall, parents in this study appeared under-prepared to meet family disaster needs, although they recognized its importance. The results suggest opportunities and methods for public health and safety planning, education and outreach to parents of children with DD who would benefit from targeted training such as information and skill building to develop effective family preparedness plans and connections to local emergency management and responders. PMID:25779895

  3. Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

    PubMed

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine (AEM) consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to: 1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; 2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and 3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified prior to the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were 164 individuals involved in the conference spanning various specialties, including emergency medicine (EM), radiology, surgery, medical physics, and the decision sciences. This issue of AEM is dedicated to the proceedings of the 16th annual AEM consensus conference as well as original research related to emergency diagnostic imaging.

  4. A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology.

    PubMed

    Burris, Scott; Ashe, Marice; Levin, Donna; Penn, Matthew; Larkin, Michelle

    2016-01-01

    Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health.

  5. Role of public transport in accessibility to emergency dental care in Melbourne, Australia.

    PubMed

    Rocha, Carla M; Kruger, Estie; McGuire, Shane; Tennant, Marc

    2015-01-01

    The aim of this study was to develop a method for the analysis of the influence of public transport supply in a large city (Melbourne) on the access to emergency dental treatment. Geographic Information Systems (GIS) tools were used to associate the geographical distribution of patients (and their socioeconomic status) with accessibility (through public transport supply, i.e. bus, tram and/or train) to emergency dental care. The methodology used allowed analysis of the socioeconomic status of patient residential areas and both spatial location and supply frequency of public transport by using existing data from patient records, census and transport departments. In metropolitan Melbourne, a total of 13 784 patients met the inclusion criteria for the study sample, of which 95% (n = 13 077) were living within a 50 km radius of the Royal Dental Hospital of Melbourne. Low socioeconomic areas had a higher demand for dental emergency care in the Royal Dental Hospital of Melbourne. Public transport supply was similar across the various socioeconomic strata in the population, with 80% of patients having good access to public transport. However, when considering only high-frequency bus stops, the percentage of patients living within 400 m from a bus stop dropped to 65%. Despite this, the number of patients (adjusted to the population) coming from areas not supplied by public transport, and from areas with good or poor public transport supply, was similar. The methodology applied in the present study highlights the importance of evaluating not only the spatial distribution but also the frequency of public transport supply when studying access to services. This methodology can be extrapolated to other settings to identity transport/access patterns for a variety of services.

  6. Can Merging the Roles of Public Health Preparedness and Emergency Management Increase the Efficiency and Effectiveness of Emergency Planning and Response?

    PubMed Central

    Vielot, Nadja A.; Horney, Jennifer A.

    2014-01-01

    Some jurisdictions have reduced workforce and reallocated responsibilities for public health preparedness and emergency management to more efficiently use resources and improve planning and response. Key informant interviews were conducted in six counties in North Carolina (USA) to discuss perceptions of the challenges and opportunities provided by the new shared positions. Respondents feel that planning and response have improved, but that requirements related to activities or equipment that are eligible for funding (particularly on the public health side) can present an impediment to consolidating public health preparedness and emergency management roles. As the financial resources available for public health preparedness and emergency management continue to be reduced, the merging of the roles and responsibilities of public health preparedness and emergency management may present jurisdictions with an effective alternative to reducing staff, and potentially, readiness. PMID:24619123

  7. From bioterrorism exercise to real-life public health crisis: lessons for emergency hotline operations.

    PubMed

    Uscher-Pines, Lori; Bookbinder, Sylvia H; Miro, Suzanne; Burke, Thomas

    2007-01-01

    Although public health agencies routinely operate hotlines to communicate key messages to the public, they are rarely evaluated to improve hotline management. Since its creation in 2003, the New Jersey Department of Health & Senior Services' Emergency Communications Center has confronted two large-scale incidents that have tested its capabilities in this area. The influenza vaccine shortage of 2004 and the April 2005 TOPOFF 3 full-scale bioterrorism exercise provided both real-life and simulated crisis situations from which to derive general insights into the strengths and weaknesses of hotline administration. This article identifies problems in the areas of staff and message management by analyzing call volume data and the qualitative observations of group feedback sessions and semistructured interviews with hotline staff. It also makes recommendations based on lessons learned to improve future hotline operations in public health emergencies.

  8. Public Health Emergency Operations Center - A critical component of mass gatherings management infrastructure.

    PubMed

    Elachola, Habidah; Al-Tawfiq, Jaffar A; Turkestani, Abdulhafiz; Memish, Ziad A

    2016-08-31

    Mass gatherings (MG) are characterized by the influx of large numbers of people with the need to have infrastructural changes to support these gatherings. Thus, Public Health Emergency Operations Center (PHEOC) is critical management infrastructure for both the delivery of public health functions and for mounting adequate response during emergencies. The recognition of the importance of PHEOC at the leadership and political level is foundational for the success of any public health intervention during MG. The ability of the PHEOC to effectively function depends on appropriate design and infrastructure, staffing and command structure, and plans and procedures developed prior to the event. Multi-ministerial or jurisdictional coordination will be required and PHEOC should be positioned with such authorities. This paper outlines the essential concepts, elements, design, and operational aspects of PHEOC during MG.

  9. Emergency Nursing, Ebola, and Public Policy: The Contributions of Nursing to the Public Policy Conversation.

    PubMed

    Wolf, Lisa; Ulrich, Connie M; Grady, Christine

    2016-09-01

    Excellent patient care within the emergency department requires interdisciplinary training, teamwork, and communication to manage the chaos of the environment. Specifically, invasive procedures required to manage airway, breathing, and circulation via intubation, chest compressions, and establishing intravenous access can provide a direct benefit to save lives but also have the potential to harm both patients and health care clinicians alike; emergency health care clinicians can be exposed to significant amounts of blood and body fluids as well as other threats of physical and psychological harm. The ethical components of care in this environment are often under-recognized due to the need for rapid patient assessment and immediate action. Moreover, challenges to practice that can include lack of qualified personnel, equipment, and other resources to provide safe care to a large volume of patients can lead to moral distress in ED staff. Because the ED is a high-uncertainty, high-acuity environment, continuing interprofessional communication, collaboration, and planning is critical. Opportunities for multidisciplinary policy dialogue and the development of professional guidelines can make the ED a safer environment for both patients and providers.

  10. The emergence of tropical medicine in Portugal: the School of Tropical Medicine and the Colonial Hospital of Lisbon (1902-1935).

    PubMed

    Amara, Isabel

    2008-01-01

    The School of Tropical Medicine was founded in 1902 along with the Colonial Hospital of Lisbon. The Portuguese government recognized the importance of colonising the tropics and therefore supported the creation of a specific locus of medical training that would prove to be crucial to the clinical and experimental study of tropical diseases. This paper examines the importance of such institutions for the emergence of a new scientific area of research while also functioning as a consolidation factor for the Third Portuguese Colonial Empire. The creation of a new concept of medical practice with respect to tropical diseases characterizes a specific aspect of colonization: it underlies and drives the discourse of colonization itself. Consultation of data collected by the Portuguese Tropical School and the Colonial Hospital during the period between 1902 and 1935, the starting point of the present study, seeks to shed light on the ongoing debate concerning the history of tropical medicine within European colonial discourse.

  11. Publication of population data of linearly inherited DNA markers in the International Journal of Legal Medicine.

    PubMed

    Parson, Walther; Roewer, Lutz

    2010-09-01

    This manuscript extends on earlier recommendations of the editor of the International Journal of Legal Medicine on short tandem repeat population data and provides details on specific criteria relevant for the analysis and publication of population studies on haploid DNA markers, i.e. Y-chromosomal polymorphisms and mitochondrial DNA. The proposed concept is based on review experience with the two forensic haploid markers databases YHRD and EMPOP, which are both endorsed by the International Society for Forensic Genetics. The intention is to provide guidance with the preparation of population studies and their results to improve the reviewing process and the quality of published data. We also suggest a minimal set of required information to be presented in the publication to increase understanding and use of the data. The outlined procedure has in part been elaborated with the editors of the journal Forensic Science International Genetics.

  12. Mobile satellite services for public safety, disaster mitigation and disaster medicine

    NASA Technical Reports Server (NTRS)

    Freibaum, Jerry

    1990-01-01

    Between 1967 and 1987 nearly three million lives were lost and property damage of $25 to $100 billion resulted form natural disasters that adversely affected more than 829 million people. The social and economic impacts have been staggering and are expected to grow more serious as a result of changing demographic factors. The role that the Mobile Satellite Service can play in the International Decade is discussed. MSS was not available for disaster relief operations during the recent Loma Prieta/San Francisco earthquake. However, the results of a review of the performance of seven other communication services with respect to public sector operations during and shortly after the earthquake are described. The services surveyed were: public and private telephone, mobile radio telephone, noncellular mobile radio, broadcast media, CB radio, ham radio, and government and nongovernment satellite systems. The application of MSS to disaster medicine, particularly with respect to the Armenian earthquake is also discussed.

  13. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  14. Factors associated with the use of emergency dental care facilities in a French public hospital.

    PubMed

    Tramini, Paul; Al Qadi Nassar, Buthaïna; Valcarcel, Jean; Gibert, Philippe

    2010-01-01

    This study was undertaken to qualitatively analyze patients' profiles and to identify the sociodemographic and oral health factors associated with emergency visits to the public dental service in Montpellier, France. A cross-sectional survey was conducted in the dental care service at Montpellier Hospital. Socioeconomic and clinical variables were compared between the patients using the emergency dental care service and those utilizing the general dental services, which were by appointment. An evaluation of the results indicated that younger patients and people from lower socioeconomic groups used the emergency dental service more frequently. Unemployed people (OR = 1.60) and manual workers (OR = 1.86) were also more likely to use this service. The need for treatment of caries was significantly higher in the group that used the emergency service. It appeared that the two groups of patients had different attendance behavior and showed significantly different socioeconomic and oral health status.

  15. German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

    PubMed Central

    Hohenstein, Christian; Fleischmann, Thomas; Rupp, Peter; Hempel, Dorothea; Wilk, Sophia; Winning, Johannes

    2016-01-01

    BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors. METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all. RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classification resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure. CONCLUSION: Communication deficits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety. PMID:27313802

  16. Public Careers and Private Sexuality: Some Gay and Lesbian Lives in the History of Medicine and Public Health

    PubMed Central

    Hansen, Bert

    2002-01-01

    This study explores the careers of 5 physicians active in public health and medicine during the first half of the 20th century to illustrate interactions between private and professional life. An examination of these individuals, who might today be variously designated as gay, lesbian, bisexual, transgender, or queer, suggests how historical understanding can be enriched by a greater willingness to investigate intimacy and sexual life as potentially relevant to career and achievements. Further, the narratives support a plea for all historians to provide readers with a more frank acknowledgment of the possible relevance of personal life to intellectual work, even in the sciences. Additionally, this historical exploration of ways that careers and achievements may have been affected by a person's homosexuality (even when the person did not publicly embrace a gay identity) opens up a new area of research through biographical sketches based on historical sources combined with generalizations that are intentionally provisional. Included are the stories of Sara Josephine Baker, Harry Stack Sullivan, Ethel Collins Dunham, Martha May Eliot, and Alan L. Hart. PMID:11772756

  17. The Cost and Burden of the Residency Match in Emergency Medicine

    PubMed Central

    Blackshaw, Aaron M.; Watson, Simon C.; Bush, Jeffrey S.

    2017-01-01

    Introduction To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Methods Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. Results In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The “average applicant” who interviewed at our residency program for the 2015–16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Conclusion Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs. PMID:28116032

  18. The Social Media Index: Measuring the Impact of Emergency Medicine and Critical Care Websites

    PubMed Central

    Thoma, Brent; Sanders, Jason L.; Lin, Michelle; Paterson, Quinten S.; Steeg, Jordon; Chan, Teresa M.

    2015-01-01

    Introduction The number of educational resources created for emergency medicine and critical care (EMCC) that incorporate social media has increased dramatically. With no way to assess their impact or quality, it is challenging for educators to receive scholarly credit and for learners to identify respected resources. The Social Media index (SMi) was developed to help address this. Methods We used data from social media platforms (Google PageRanks, Alexa Ranks, Facebook Likes, Twitter Followers, and Google+ Followers) for EMCC blogs and podcasts to derive three normalized (ordinal, logarithmic, and raw) formulas. The most statistically robust formula was assessed for 1) temporal stability using repeated measures and website age, and 2) correlation with impact by applying it to EMCC journals and measuring the correlation with known journal impact metrics. Results The logarithmic version of the SMi containing four metrics was the most statistically robust. It correlated significantly with website age (Spearman r=0.372; p<0.001) and repeated measures through seven months (r=0.929; p<0.001). When applied to EMCC journals, it correlated significantly with all impact metrics except number of articles published. The strongest correlations were seen with the Immediacy Index (r=0.609; p<0.001) and Article Influence Score (r=0.608; p<0.001). Conclusion The SMi’s temporal stability and correlation with journal impact factors suggests that it may be a stable indicator of impact for medical education websites. Further study is needed to determine whether impact correlates with quality and how learners and educators can best utilize this tool. PMID:25834664

  19. 78 FR 60283 - Guidance for Temporary Reassignment of State and Local Personnel During a Public Health Emergency

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ... HUMAN SERVICES Guidance for Temporary Reassignment of State and Local Personnel During a Public Health... (PAHPRA), Public Law 113-5, amends section 319 of the Public Health Service (PHS) Act to provide the... personnel during a declared Federal public health emergency upon request by a state or tribal...

  20. Communication of emergency public warnings: A social science perspective and state-of-the-art assessment

    SciTech Connect

    Mileti, D.S. ); Sorensen, J.H. )

    1990-08-01

    More than 200 studies of warning systems and warning response were reviewed for this social science perspective and state-of-the-art assessment of communication of emergency public warnings. The major findings are as follows. First, variations in the nature and content of warnings have a large impact on whether or not the public heeds the warning. Relevant factors include the warning source; warning channel; the consistency, credibility, accuracy, and understandability of the message; and the warning frequency. Second, characteristics of the population receiving the warning affect warning response. These include social characteristics such as gender, ethnicity and age, social setting characteristics such as stage of life or family context, psychological characteristics such as fatalism or risk perception, and knowledge characteristics such as experience or training. Third, many current myths about public response to emergency warning are at odds with knowledge derived from field investigations. Some of these myths include the keep it simple'' notion, the cry wolf'' syndrome, public panic and hysteria, and those concerning public willingness to respond to warnings. Finally, different methods of warning the public are not equally effective at providing an alert and notification in different physical and social settings. Most systems can provide a warning given three or more hours of available warning time. Special systems such as tone-alert radios are needed to provide rapid warning. 235 refs., 8 figs., 2 tabs.

  1. Emergency preparedness and bioterrorism response: development of an educational program for public health personnel.

    PubMed

    Baldwin, Karen; Lamantia, Joanne; Prozialeck, Linda; Proziack, Linda

    2005-01-01

    Public health departments are under increasing pressure to provide emergency preparedness and bioterrorism response education to public health personnel. The challenge that health departments face is to provide cost-efficient, timely education to a large number of multidisciplinary personnel. This article describes an innovative strategy for providing this education to public health personnel using the health department's intranet system. The intranet system provided confidential information specific to the staff role and allowed for concurrent access to the program by multiple individuals at different service sites. Knowledge acquisition was tested through short multiple-choice questions that followed the specific information modules. The intranet system faced a number of challenges during the pilot-testing phase, primarily related to changes in the role of the public health nurse and limitations in funding and public health staff to maintain and monitor the bioterrorism response program and the intranet system. The design of the program may prove useful for other public health organizations when a need exists for quick delivery of information to a large number of personnel. It may especially be useful in providing basic emergency preparedness and bioterrorism education to new personnel in health departments.

  2. Biomedicalization and the public sphere: newspaper coverage of health and medicine, 1960s-2000s.

    PubMed

    Hallin, Daniel C; Brandt, Marisa; Briggs, Charles L

    2013-11-01

    This article examines historical trends in the reporting of health and medicine in The New York Times and Chicago Tribune from the 1960s to the 2000s. It focuses on the extent to which health reporting can be said to have become increasingly politicized, or to have shifted from treating the production of medical knowledge as something belonging to a restricted, specialized sphere, to treating it as a part of the general arena of public debate. We coded a sample of 400 stories from the two newspapers for four different Implied Audiences which health stories can address: Scientific/Professional, Patient/Consumer, Investor and Citizen/Policymaker. Stories were also coded for the origin of the story, the sources cited, the presence of controversy, and the positive or negative representation of biomedical institutions and actors. The data show that through all five decades, news reporting on health and medicine addressed readers as Citizen/Policymakers most often, though Patient/Consumer and Investor-oriented stories increased over time. Biomedical researchers eclipsed individual physicians and public health officials as sources of news, and the sources diversified to include more business sources, civil society organizations and patients and other lay people. The reporting of controversy increased, and portrayals of biomedicine shifted from lopsidedly positive to more mixed. We use these data in pinpointing how media play a constitutive role in the process of "biomedicalization," through which biomedicine has both extended its reach into and become entangled with other spheres of society and of knowledge production.

  3. Treatment of uncomplicated malaria at public health facilities and medicine retailers in south-eastern Nigeria

    PubMed Central

    2011-01-01

    Background At primary care facilities in Nigeria, national treatment guidelines state that malaria should be symptomatically diagnosed and treated with artemisinin-based combination therapy (ACT). Evidence from households and health care providers indicates that many patients do not receive the recommended treatment. This study sought to determine the extent of the problem by collecting data as patients and caregivers leave health facilities, and determine what influences the treatment received. Methods A cross-sectional cluster survey of 2,039 respondents exiting public health centres, pharmacies and patent medicine dealers was undertaken in urban and rural settings in Enugu State, south-eastern Nigeria. Results Although 79% of febrile patients received an anti-malarial, only 23% received an ACT. Many patients (38%) received sulphadoxine-pyrimethamine (SP). A further 13% of patients received an artemisinin-derivative as a monotherapy. An estimated 66% of ACT dispensed was in the correct dose. The odds of a patient receiving an ACT was highly associated with consumer demand (OR: 55.5, p < 0.001). Conclusion Few febrile patients attending public health facilities, pharmacies and patent medicine dealers received an ACT, and the use of artemisinin-monotherapy and less effective anti-malarials is concerning. The results emphasize the importance of addressing both demand and supply-side influences on malaria treatment and the need for interventions that target consumer preferences as well as seek to improve health service provision. PMID:21651787

  4. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    PubMed

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  5. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013).

    PubMed

    Cadogan, Mike; Thoma, Brent; Chan, Teresa M; Lin, Michelle

    2014-10-01

    Disruptive technologies are revolutionising continuing professional development in emergency medicine and critical care (EMCC). Data on EMCC blogs and podcasts were gathered prospectively from 2002 through November 2013. During this time there was a rapid expansion of EMCC websites, from two blogs and one podcast in 2002 to 141 blogs and 42 podcasts in 2013. This paper illustrates the explosive growth of EMCC websites and provides a foundation that will anchor future research in this burgeoning field.

  6. Antagonism and accommodation: interpreting the relationship between public health and medicine in the United States during the 20th century.

    PubMed Central

    Brandt, A M; Gardner, M

    2000-01-01

    Throughout the course of the 20th century, many observers have noted important tensions and antipathies between public health and medicine. At the same time, reformers have often called for better engagement and collaboration between the 2 fields. This article examines the history of the relationship between medicine and public health to examine how they developed as separate and often conflicting professions. The historical character of this relationship can be understood only in the context of institutional developments in professional education, the rise of the biomedical model of disease, and the epidemiologic transition from infectious disease to the predominance of systemic chronic diseases. Many problems in the contemporary burden of disease pose opportunities for effective collaborations between population-based and clinical interventions. A stronger alliance between public health and medicine through accommodation to a reductionist biomedicine, however, threatens to subvert public health's historical commitment to understanding and addressing the social roots of disease. PMID:10800418

  7. [Development of an instrument for the surveillance of quality indicators in specialized training in Preventive Medicine and Public Health].

    PubMed

    Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe

    2015-01-01

    This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries.

  8. Understanding the nature of health: New perspectives for medicine and public health. Improved wellbeing at lower costs

    PubMed Central

    Bircher, Johannes; Hahn, Eckhart G.

    2016-01-01

    Background: Current dilemmas of health care systems call for a new look at the nature of health. This is offered by the Meikirch model. We explore its hypothetical benefit for the future of medicine and public health. Meikirch model: It states: “Health is a dynamic state of wellbeing emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants.” “Throughout the life course health results when an individuals’ biologically given potential (BGP) and his or her personally acquired potential (PAP), interacting with social and environmental determinants, satisfactorily respond to the demands of life.” Methods: We explored the Meikirch model’s possible applications for personal and public health care. Results: The PAP of each individual is the most modifiable component of the model. It responds to constructive social interactions and to personal growth. If an individual’s PAP is nurtured to develop further, it likely will contribute much more to health than without fostering. It may also compensate for losses of the BGP. An ensuing new culture of health may markedly improve health in the society. The rising costs of health care presumably are due in part to the tragedy of the commons and to moral hazard. Health as a complex adaptive system offers new possibilities for patient care, particularly for general practitioners. Discussion: Analysis of health systems by the Meikirch model reveals that in many areas more can be done to improve people’s health and to reduce health care costs than is done today. The Meikirch model appears promising for individual and public health in low and high income countries. Emphasizing health instead of disease the Meikirch model reinforces article 12 of the International Covenant on Economic, Social and Cultural Rights of the United Nations – that abandons the WHO definition - and thereby may contribute to its reinterpretation. PMID:27134730

  9. A one-time-only combination: Emergency medicine exports and the TRIPS agreement under Canada's access to medicines regime.

    PubMed

    Weber, Ashley; Mills, Lisa

    2010-06-15

    In 2008, a Canadian generic pharmaceutical firm, Apotex Inc. (Apotex), shipped 7 million doses of antiretroviral drugs to Rwanda for the treatment of HIV/AIDS. While this event may be seen as a positive outcome of international patent changes that facilitate the fulfillment of health as a human right, the fact that there has been only one shipment of medication in response to these changes highlights the difficulties with both the Canadian legislation and with the international decisions that it implements. The shipment was authorized under Canada's Access to Medicines Regime (CAMR), which implements the World Trade Organization (WTO) General Council Decision (the Decision), made in 2003, to permit someone other than the patent holder to manufacture a lower-cost version of a patented drug or medical device for export to developing countries that do not have the capacity to manufacture such products. The Decision requires that the developing country announce its intention to use this mechanism, to specify the expected quantity of drugs to be supplied, and to issue a compulsory license for the drugs. The requirement of notification in particular may render developing countries vulnerable to pressure from pharmaceutical firms. Neither the mechanism created by the Decision nor Canadian legislation implementing it have facilitated the export of generic medicines to developing countries. To date, the Canadian shipment is the only one to have occurred using the WTO mechanism.

  10. Applying behavioral science to workforce challenges in the public health emergency preparedness system.

    PubMed

    McCabe, O Lee; DiClemente, Carlo C; Links, Jonathan M

    2012-01-01

    When disasters and other broad-scale public health emergencies occur in the United States, they often reveal flaws in the pre-event preparedness of those individuals and agencies charged with responsibility for emergency response and recovery activities. A significant contributor to this problem is the unwillingness of some public health workers to participate in the requisite planning, training, and response activities to ensure quality preparedness. The thesis of this article is that there are numerous, empirically supported models of behavior change that hold potential for motivating role-appropriate behavior in public health professionals. The models that are highlighted here for consideration and prospective adaptation to the public health emergency preparedness system (PHEPS) are the Transtheoretical Model of Intentional Behavior Change (TTM) and Motivational Interviewing (MI). Core concepts in TTM and MI are described, and specific examples are offered to illustrate the relevance of the frameworks for understanding and ameliorating PHEPS-based workforce problems. Finally, the requisite steps are described to ensure the readiness of organizations to support the implementation of the ideas proposed.

  11. Residents values in a rational decision-making model: an interest in academics in emergency medicine.

    PubMed

    Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

    2016-10-01

    Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career.

  12. A world wide public health problem: the principal re-emerging infectious diseases.

    PubMed

    De Luca D'Alessandro, E; Giraldi, G

    2011-01-01

    The extraordinary progress in the knowledge of infectious disease, the discovery of antibiotics and effective vaccines are among the great achievement of the nineteenth and twentieth centuries. These achievement have led to a dramatic reduction in the levels of mortality from these diseases. According to the World Health Organization, the term "re-emerging infectious diseases" refers to infectious diseases, which although well known, have not been of recent public health importance. However, climate change, migration, changes in health services, antibiotic resistance, population increase, international travel, the increase in the number of immune-depressed patients ,etc have lead to the re-emergence of these diseases. The climate changes are exposing sectors of the population to inadequate fresh air, water, food and resources for survival which, in consequence, provoke increases in both internal and international migration. In this particular period in which we find ourselves, characterized by globalization, the international community has become aware that the re-emergence of these diseases poses an important risk for public health underlines the necessity to adopt appropriate strategies for their prevention and control. The re-emerging diseases of the twenty-first century are a serious problem for public health and even though there has been enormous progress in medical science and in the battle against infectious diseases, they are still a long way from being really brought under control. A well organized monitoring system would enable the epidemiological characteristics of the infectious diseases to be analyzed and the success or otherwise of preventive interventions to be precisely evaluated. For this reason, the World Health Organization and the European Union have discussed the formation of a collaborative network for the monitoring and control of re-emerging diseases and has initiated special programmes. The battle between humanity and infectious disease

  13. Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care.

    PubMed

    Bell, Iris R; Caspi, Opher; Schwartz, Gary E R; Grant, Kathryn L; Gaudet, Tracy W; Rychener, David; Maizes, Victoria; Weil, Andrew

    2002-01-28

    Clinicians and researchers are increasingly using the term integrative medicine to refer to the merging of complementary and alternative medicine (CAM) with conventional biomedicine. However, combination medicine (CAM added to conventional) is not integrative. Integrative medicine represents a higher-order system of systems of care that emphasizes wellness and healing of the entire person (bio-psycho-socio-spiritual dimensions) as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship. Using the context of integrative medicine, this article outlines the relevance of complex systems theory as an approach to health outcomes research. In this view, health is an emergent property of the person as a complex living system. Within this conceptualization, the whole may exhibit properties that its separate parts do not possess. Thus, unlike biomedical research that typically examines parts of health care and parts of the individual, one at a time, but not the complete system, integrative outcomes research advocates the study of the whole. The whole system includes the patient-provider relationship, multiple conventional and CAM treatments, and the philosophical context of care as the intervention. The systemic outcomes encompass the simultaneous, interactive changes within the whole person.

  14. Public Health Emergency Planning for Children in Chemical, Biological, Radiological, and Nuclear (CBRN) Disasters

    PubMed Central

    Bartenfeld, Michael T.; Peacock, Georgina; Griese, Stephanie E.

    2015-01-01

    Children represent nearly a quarter of the US population, but their unique needs in chemical, biological, radiological, and nuclear (CBRN) emergencies may not be well understood by public health and emergency management personnel or even clinicians. Children are different from adults physically, developmentally, and socially. These characteristics have implications for providing care in CBRN disasters, making resulting illness in children challenging to prevent, identify, and treat. This article discusses these distinct physical, developmental, and social traits and characteristics of children in the context of the science behind exposure to, health effects from, and treatment for the threat agents potentially present in CBRN incidents. PMID:25014894

  15. The common ground preparedness framework: a comprehensive description of public health emergency preparedness.

    PubMed

    Gibson, P Joseph; Theadore, Fred; Jellison, James B

    2012-04-01

    Currently, public health emergency preparedness (PHEP) is not well defined. Discussions about public health preparedness often make little progress, for lack of a shared understanding of the topic. We present a concise yet comprehensive framework describing PHEP activities. The framework, which was refined for 3 years by state and local health departments, uses terms easily recognized by the public health workforce within an information flow consistent with the National Incident Management System. To assess the framework's completeness, strengths, and weaknesses, we compare it to 4 other frameworks: the RAND Corporation's PREPARE Pandemic Influenza Quality Improvement Toolkit, the National Response Framework's Public Health and Medical Services Functional Areas, the National Health Security Strategy Capabilities List, and the Centers for Disease Control and Prevention's PHEP Capabilities.

  16. The Common Ground Preparedness Framework: A Comprehensive Description of Public Health Emergency Preparedness

    PubMed Central

    Theadore, Fred; Jellison, James B.

    2012-01-01

    Currently, public health emergency preparedness (PHEP) is not well defined. Discussions about public health preparedness often make little progress, for lack of a shared understanding of the topic. We present a concise yet comprehensive framework describing PHEP activities. The framework, which was refined for 3 years by state and local health departments, uses terms easily recognized by the public health workforce within an information flow consistent with the National Incident Management System. To assess the framework's completeness, strengths, and weaknesses, we compare it to 4 other frameworks: the RAND Corporation's PREPARE Pandemic Influenza Quality Improvement Toolkit, the National Response Framework's Public Health and Medical Services Functional Areas, the National Health Security Strategy Capabilities List, and the Centers for Disease Control and Prevention's PHEP Capabilities. PMID:22397343

  17. 77 FR 55891 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for AIDS Relief...

  18. 76 FR 52731 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... open to the public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for AIDS Relief...

  19. 78 FR 55326 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... is open to the public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for...

  20. Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning

    PubMed Central

    Parker, Miles; Acland, Andrew; Armstrong, Harry J.; Bellingham, Jim R.; Bland, Jessica; Bodmer, Helen C.; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D.; Cope, David; Costanzo, Lucia; Dolan, James A.; Doubleday, Robert; Feng, Wai Yi; Godfray, H. Charles J.; Good, David A.; Grant, Jonathan; Green, Nick; Groen, Arnoud J.; Guilliams, Tim T.; Gupta, Sunjai; Hall, Amanda C.; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A.; Lueshi, Leila M.; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J.; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A.; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P.; Watkinson, Andrew R.; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K. A.; Worts, Kim; Sutherland, William J.

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security. PMID:24879444

  1. Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

    PubMed

    Parker, Miles; Acland, Andrew; Armstrong, Harry J; Bellingham, Jim R; Bland, Jessica; Bodmer, Helen C; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D; Cope, David; Costanzo, Lucia; Dolan, James A; Doubleday, Robert; Feng, Wai Yi; Godfray, H Charles J; Good, David A; Grant, Jonathan; Green, Nick; Groen, Arnoud J; Guilliams, Tim T; Gupta, Sunjai; Hall, Amanda C; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A; Lueshi, Leila M; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P; Watkinson, Andrew R; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K A; Worts, Kim; Sutherland, William J

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

  2. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: Paediatric deaths associated with over the counter cough and cold medicines.

    PubMed

    Deschler, Deanna; Judge, Bryan

    2014-02-01

    A short cut review was carried out to establish whether over the counter cough and cold medicines were associated with unexpected deaths in childhood. 115 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that while over the counter cough and cold medications may be associated with unexpected paediatric deaths, the degree of risk is not clear.

  3. Ebola Hemorrhagic Fever as a Public Health Emergency of International Concern; a Review Article.

    PubMed

    Safari, Saeed; Baratloo, Alireza; Rouhipour, Alaleh; Ghelichkhani, Parisa; Yousefifard, Mahmood

    2015-01-01

    Ebola hemorrhagic fever (EHF) was first reported in 1976 with two concurrent outbreaks of acute viral hemorrhagic fever centered in Yambuku (near the Ebola river), Democratic Republic of Congo, and in Nzara, Sudan. The current outbreak of the Ebola virus was started by reporting the first case in March 2014 in the forest regions of southeastern Guinea. Due to infection rates raising over 13,000% within a 6-month period, Ebola is now considered as a global public health emergency and on August 8(th), 2014 the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern. With more than 5000 involved cases and nearly 3000 deaths, this event has turned into the largest and most dangerous Ebola virus outbreak in the world. Based on the above-mentioned, the present article aimed to review the virologic characteristics, transmission, clinical manifestation, diagnosis, treatment, and prevention of Ebola virus disease.

  4. The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): The First 10 Years and a Look at Public Perception of Emergency Medical Services (EMS).

    PubMed

    Crowe, Remle P; Bentley, Melissa A; Levine, Roger

    2016-12-01

    Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.

  5. Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan.

    PubMed

    Wells, Eden V; Benn, Rita K; Warber, Sara L

    2015-11-01

    The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned.

  6. Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

    PubMed

    Safdar, Basmah; Greenberg, Marna R

    2014-12-01

    With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

  7. Characterizing the limited use of point-of-care ultrasound in Colombian emergency medicine residencies

    PubMed Central

    2014-01-01

    Background Emergency medicine (EM) is a growing specialty in Colombia with five residency programs in the country. EM leadership is interested in incorporating point-of-care (POC) ultrasound into a standardized national EM residency curriculum. This study is a nationwide survey of Colombian EM residents designed to explore the current state of POC ultrasound use within EM residencies and examine specific barriers preventing its expansion. Methods We conducted a mix-methodology study of all available current EM residents in the five EM residencies in Colombia. The quantitative survey assessed previous ultrasound experience, current use of various applications, desire for further training, and perceived barriers to expanded use. Focus group discussions (FGDs) were conducted with current EM residents to gather additional qualitative insight into their practice patterns and perceived barriers to clinician-performed ultrasound. Results Sixty-nine EM residents completed the quantitative survey, a response rate of 85% of all current EM residents in Colombia; 52% of resident respondents had previously used ultrasound during their training. Of these, 58% indicated that they had performed <10 scans and 17% reported >40 scans. The most frequently used applications indicated by respondents were trauma, obstetrics, and procedures including vascular access. A quarter indicated they had previously received some ultrasound training, but almost all expressed an interest in learning more. Significant barriers included lack of trained teachers (indicated by 78% of respondents), absence of machines (57%), and limited time (41%). In FGDs, the barriers identified were inter-specialty conflicts over the control of ultrasonography, both institutionally and nationally, and program-specific curriculum decisions to include POC ultrasound. Conclusion While currently limited in their access, EM residents in Colombia have a strong interest in integrating POC ultrasound into their training

  8. Teaching Emotional Intelligence: A Control Group Study of a Brief Educational Intervention for Emergency Medicine Residents

    PubMed Central

    Gorgas, Diane L.; Greenberger, Sarah; Bahner, David P.; Way, David P.

    2015-01-01

    Introduction Emotional Intelligence (EI) is defined as an ability to perceive another’s emotional state combined with an ability to modify one’s own. Physicians with this ability are at a distinct advantage, both in fostering teams and in making sound decisions. Studies have shown that higher physician EI’s are associated with lower incidence of burn-out, longer careers, more positive patient-physician interactions, increased empathy, and improved communication skills. We explored the potential for EI to be learned as a skill (as opposed to being an innate ability) through a brief educational intervention with emergency medicine (EM) residents. Methods This study was conducted at a large urban EM residency program. Residents were randomized to either EI intervention or control groups. The intervention was a two-hour session focused on improving the skill of social perspective taking (SPT), a skill related to social awareness. Due to time limitations, we used a 10-item sample of the Hay 360 Emotional Competence Inventory to measure EI at three time points for the training group: before (pre) and after (post) training, and at six-months post training (follow up); and at two time points for the control group: pre- and follow up. The preliminary analysis was a four-way analysis of variance with one repeated measure: Group x Gender x Program Year over Time. We also completed post-hoc tests. Results Thirty-three EM residents participated in the study (33 of 36, 92%), 19 in the EI intervention group and 14 in the control group. We found a significant interaction effect between Group and Time (p≤0.05). Post-hoc tests revealed a significant increase in EI scores from Time 1 to 3 for the EI intervention group (62.6% to 74.2%), but no statistical change was observed for the controls (66.8% to 66.1%, p=0.77). We observed no main effects involving gender or level of training. Conclusion Our brief EI training showed a delayed but statistically significant positive impact

  9. Emergency Medicine Resident Orientation: How Training Programs Get Their Residents Started

    PubMed Central

    McGrath, Jillian; Barrie, Michael; Way, David P.

    2017-01-01

    Introduction The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States. Methods In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167). We adapted our survey instrument from one used by Brillman (1995). The survey was designed to assess the orientation program’s purpose, structure, content, and teaching methods. Results The survey return rate was 63% (105 of 167). Most respondents (77%) directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3) and 13 non-clinical days (Std. Dev.=9.3). The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98%) and with other members of the department (91%). Many programs (87%) included special certification courses (ACLS, ATLS, PALS, NRP). Course content included the following: use of electronic medical records (90%), physician wellness (75%), and chief complaint-based lectures (72%). Procedural skill sessions covered ultrasound (94%), airway management (91%), vascular access (90%), wound management (77%), splinting (67%), and trauma skills (62%). Conclusion Compared to Brillman (1995), we found that more programs (99%) are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty

  10. Testifying in court: practical strategies for public safety, emergency services, and mental health professionals.

    PubMed

    Miller, Laurence

    2009-01-01

    Testifying in court can be an opportunity or an ordeal for public safety, emergency services, and mental health personnel, depending on the stakes involved and the status of the professional--fact witness, expert witness, or defendant. This article provides practical guidelines for effective courtroom testimony, including understanding your role in the legal process, knowing your case, preparing your testimony, using optimal presentation strategies, manifesting appropriate demeanor and body language, answering questions, parrying challenges, and carrying yourself overall as a dignified professional.

  11. An Overview of the U.S. Public Health System in the Context of Emergency Preparedness

    DTIC Science & Technology

    2005-03-17

    Secretary of HHS the authority to declare a situation a public health emergency, which triggers an expansion of federal authority (such as federal...Migration and Quarantine Home Page at [http://www.cdc.gov/ncidod/dq/index.htm], and section on Protection Against Communicable Diseases in CRS Report...activities can be found at [http://www.fda.gov/ oc/opacom/hottopics/bioterrorism.html]. 14 See the NIAID Biodefense Home Page at [http://www2

  12. Selected resources for emergency and disaster preparedness and response from the United States National Library of Medicine.

    PubMed

    Hochstein, Colette; Arnesen, Stacey; Goshorn, Jeanne; Szczur, Marti

    2008-01-01

    The Toxicology and Environmental Health Information Program (TEHIP) of the National Library of Medicine (NLM) works to organize and provide access to a wide range of environmental health and toxicology resources. In recent years, the demand for, and availability of, information on health issues related to natural and man-made emergencies and disasters has increased. Recognizing that access to information is essential in disaster preparedness, a new focus of NLM's 2006-2016 Long Range Plan calls for the establishment of a Disaster Information Management Research Center (DIMRC) that will aid in collecting, disseminating, and sharing information related to health and disasters. This paper introduces several of TEHIP's resources for emergency/disaster preparedness and response, such as the Radiation Event Medical Management Web site (REMM) and the Wireless Information System for Emergency Responders (WISER) . Several of NLM's other disaster preparedness and response resources will also be reviewed.

  13. Investigation of public exposure resulted from the radioiodine delay tank facility of nuclear medicine department

    SciTech Connect

    Yusof, Mohd Fahmi Mohd Ali, Abdul Muhaimin Mat; Abdullah, Reduan; Idris, Abdullah Waidi

    2016-01-22

    The study is carried out to assess the exposure rate that could contribute to public exposure in a radioiodine ward delay tank facility of Radiotherapy, Oncology and Nuclear Medicine, Department, Hospital Universiti Sains Malaysia (HUSM). The exposure rate at several locations including the delay tank room, doorway and at the public walking route was measured using Victoreen 415P-RYR survey meter. The radioactive level of the {sup 131}I waste was measured using Captus 3000 well counting system. The results showed that exposure rate and total count of the delay tank sample increased when the radioiodine ward was fully occupied with patient and reduced when the ward was vacant. Occupancy of radioiodine ward for two consecutive weeks had dramatically increased the exposure rate around the delay tank and radioactive level of {sup 131}I waste. The highest exposure rate and radioactive level was recorded when the ward was occupied for two consecutive weeks with 177.00 µR/h and 58.36 kcpm respectively. The exposure rate decreased 15.76 % when the door of the delay tank room was closed. The exposure rate at public walking route decreased between 15.58 % and 36.92 % as the distance increased between 1 and 3 m.

  14. [Dr Ante Svalba (1903-1989): promotor of social medicine and public health].

    PubMed

    Bakasun, Vjekoslav

    2009-01-01

    When a healthcare professional sticks to one area of activity, such as protection of human environment, for his entire career, he must leave an indelible mark on his colleagues and local population. Dr Ante Svalba was this kind of a man; he was a physician specialised in hygiene, who persisted in his commitment to improve public health in the wide Rijeka area for nearly sixty active years. He was a true field worker and tireless educator dedicated to improving health culture in all age groups, but especially in schoolchildren. For decades, and nearly to the day he died, he was active in Red Cross work. Ante Svalba was born in Rijeka, and completed primary and secondary school in Rijeka and Susak, respectively. He graduated from the School of Medicine in Zagreb in 1927. For three years he worked at the School of Public Health in Zagreb, and between 1931 and 1942 he was town physician of Susak, until he was interned in Italy with his family. When Italy capitulated he went to Bari and joined anti-fascist resistance. In a place called Grumo he set up a hospital and a medical corps school of the National Liberation Army of Yugoslavia. Having returned to Rijeka, he performed a number of healthcare public offices, of which sanitation inspection was the longest lasting. When he retired in 1965, he took up a position of the head of Hygiene and Epidemiology Department of the Community Health Centre of Opatija until 1972.

  15. Investigation of public exposure resulted from the radioiodine delay tank facility of nuclear medicine department

    NASA Astrophysics Data System (ADS)

    Yusof, Mohd Fahmi Mohd; Ali, Abdul Muhaimin Mat; Abdullah, Reduan; Idris, Abdullah Waidi

    2016-01-01

    The study is carried out to assess the exposure rate that could contribute to public exposure in a radioiodine ward delay tank facility of Radiotherapy, Oncology and Nuclear Medicine, Department, Hospital Universiti Sains Malaysia (HUSM). The exposure rate at several locations including the delay tank room, doorway and at the public walking route was measured using Victoreen 415P-RYR survey meter. The radioactive level of the 131I waste was measured using Captus 3000 well counting system. The results showed that exposure rate and total count of the delay tank sample increased when the radioiodine ward was fully occupied with patient and reduced when the ward was vacant. Occupancy of radioiodine ward for two consecutive weeks had dramatically increased the exposure rate around the delay tank and radioactive level of 131I waste. The highest exposure rate and radioactive level was recorded when the ward was occupied for two consecutive weeks with 177.00 µR/h and 58.36 kcpm respectively. The exposure rate decreased 15.76 % when the door of the delay tank room was closed. The exposure rate at public walking route decreased between 15.58 % and 36.92 % as the distance increased between 1 and 3 m.

  16. Ultrasound in sports medicine: relevance of emerging techniques to clinical care of athletes.

    PubMed

    Yim, Eugene Sun; Corrado, Gianmichael

    2012-08-01

    The applications of ultrasound in managing the clinical care of athletes have been expanding over the past decade. This review provides an analysis of the research that has been published regarding the use of ultrasound in athletes and focuses on how these emerging techniques can impact the clinical management of athletes by sports medicine physicians. Electronic database literature searches were performed using the subject terms 'ultrasound' and 'athletes' from the years 2003 to 2012. The following databases were searched: PubMed, Web of Science, Cochrane Library, CINAHL, and SPORTDiscus™. The search produced 617 articles in total, with a predominance of articles focused on cardiac and musculoskeletal ultrasound. 266 of the studies involved application of ultrasound in evaluating the cardiovascular properties of athletes, and 151 studies involved musculoskeletal ultrasound. Other applications of ultrasound included abdominal, vascular, bone density and volume status. New techniques in echocardiography have made significant contributions to the understanding of the physiological changes that occur in the athlete's heart in response to the haemodynamic stress associated with different types of activity. The likely application of these techniques will be in managing athletes with hypertrophic cardiomyopathy, and the techniques are near ready for application into clinical practice. These techniques are highly specialized, however, and will require referral to dedicated laboratories to influence the clinical management of athletes. Investigation of aortic root pathology and pulmonary vascular haemodynamics are also emerging, but will require additional studies with larger numbers and outcomes analysis to validate their clinical utility. Some of these techniques are relatively simple, and thus hold the potential to enter clinical management in a point-of-care fashion. Musculoskeletal ultrasound has demonstrated a number of diagnostic and therapeutic techniques

  17. Federal interagency communication strategies for addressing radiation emergencies and other public health crises.

    PubMed

    Miller, Charles W; McCurley, M Carol

    2011-11-01

    Federal agencies have a variety of roles and responsibilities related to communicating with the public before, during, and after a radiological emergency. To better understand the various efforts currently underway, the Radiation Studies Branch of the Centers for Disease Control and Prevention convened a roundtable of representatives from federal agencies with responsibility for communicating with the public about radiation emergencies. Roundtable participants shared valuable information about efforts underway to develop information and messages for a variety of audiences and agreed that continued interagency coordination and dialogue about communication before, during, and after an event are needed. The group suggested several strategies for future collaborative efforts and indicated a desire to continue working together to develop and assess messages for radiological emergency preparedness and response. The group also recommended that more work be done to determine whether messages need to be packaged or tailored for specific special populations and suggested that more research be conducted to answer questions about specific audience/cultural needs around communicating radiation risks. Since this roundtable, attendees have continued to work together to develop and test messages for the public.

  18. Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.

    PubMed

    O'Donnell, John C

    2013-01-01

    The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. Moreover, many involved in the advancement of personalized medicine would view emerging approaches to stratify patients in meaningful ways beyond genomic information as a signal of the progress made. Yet despite these advances, there remains a general sense of dissatisfaction about the progress of personalized medicine in terms of its contribution to the drug development process, to the efficiency and effectiveness of health care delivery, and ultimately to the provision of the right treatment to the right patient at the right time. Academicians, payers, and manufacturers alike are struggling not only with how to embed the new insights that personalized medicine promises but also with the fundamental issues of application in early drug development, implications for health technology assessment, new demands on traditional health economic and outcomes research methods, and implications for reimbursement and access. In fact, seemingly prosaic issues such as the definition and composition of the term "personalized medicine" are still unresolved. Regardless of these issues, practitioners are increasingly compelled to find practical solutions to the challenges and opportunities presented by the evolving face of personalized medicine today. Accordingly, the articles comprising this Special Issue offer applied perspectives geared toward professionals and policymakers in the field grappling with developing, assessing, implementing, and reimbursing personalized medicine approaches. Starting with a framework with which to characterize personalized medicine, this Special Issue proceeds to

  19. Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa.

    PubMed

    Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N

    2016-04-15

    After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs.

  20. Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa

    PubMed Central

    Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N.

    2016-01-01

    After the launch of the US President’s Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson, and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sector to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. PMID:27025696