JRSM short reports最新文献_第6页

Junior doctors and healthcare reforms: are they ready? A questionnaire study 初级医生和医疗改革:他们准备好了吗?问卷调查研究

JRSM short reports Pub Date : 2013-05-01 DOI: 10.1177/2042533313476695

S. Palazzo, O. Chehab

{"title":"Junior doctors and healthcare reforms: are they ready? A questionnaire study","authors":"S. Palazzo, O. Chehab","doi":"10.1177/2042533313476695","DOIUrl":"https://doi.org/10.1177/2042533313476695","url":null,"abstract":"Summary Objectives To assess the awareness, understanding and opinions of National Health Service (NHS) reforms among foundation year junior doctors. Design Participants completed a 16 question online survey, consisting of multiple-choice questions and questions with free text responses. Setting Foundation doctors were all working within one of the four London, Oxford or Severn foundation schools. Participants One hundred and two foundation year junior doctors. Main outcome measures Understanding and awareness of NHS reforms and health politics in general as assessed through six free text and multiple-choice answersto a set of basic factual questions. Opinions of the reforms were assessed through Likert scale (1–5) responses to seven questions. Results Basic understanding of health politics and NHS reforms was poor, even on issues affecting future training. A total of 17.7% could not name the health secretary, 66.7% did not know the budget of the NHS and 71.6% did not know who would be responsible for healthcare commissioning after the reforms. A total of 68.7% of respondents reported being interested in the reforms and 63.7% reported being concerned about their effect on their own career path. Despite this, 63.7% self-reported poor understanding of the NHS reforms and 90.2% felt they would value formal education on the current changes. Conclusions Despite being interested and concerned, junior doctors are surprisingly uninformed about the NHS reforms. Given the findings of this study, more work needs to be done to educate the current cohort of medical students and foundation year doctors and engage them with the changes taking place.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"35 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2042533313476695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66144108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Injuries associated with recreational horse riding and changes over the last 20 years: a review. 近20年来与休闲骑马相关的伤害及其变化:综述。

JRSM short reports Pub Date : 2013-04-22 Print Date: 2013-05-01 DOI: 10.1177/2042533313476688

Nemandra Sandiford, Christopher Buckle, Uthman Alao, Jerome Davidson, James Ritchie

{"title":"Injuries associated with recreational horse riding and changes over the last 20 years: a review.","authors":"Nemandra Sandiford, Christopher Buckle, Uthman Alao, Jerome Davidson, James Ritchie","doi":"10.1177/2042533313476688","DOIUrl":"https://doi.org/10.1177/2042533313476688","url":null,"abstract":"Objective To assess the incidence and distribution of recreational equestrian injuries seen in the Kent and Sussex region and review the available literature on this subject. Design This is a retrospective case series with historical controls. Setting Kent and Sussex region, England. Main outcome measurement Injuries related to horses in the recreational setting. Methods Subjects were selected from our acute injury database. Notes of all patients presenting with horse riding-related injuries between January and December 2010 were reviewed. Skeletal injuries were confirmed using our Picture Archiving and Communications Systems (PACS) system. Data were tabulated and grouped using Microsoft Excel software. Statistics were calculated using Graph Pad software. Results During the study period, 155 patients presented with a total of 199 injuries related to horses, accounting for 0.3% of all presentations; 69% were soft tissue injuries. The most commonly affected areas were the extremities (77 patients, 49.7%) followed by injuries to the head (38 patients, 24.5%) and trunk (36 patients, 23.2%). Seventeen patients (11%) were admitted. Patients presenting with head injuries suffered significantly more injuries compared to other groups (1.65 compared to 1.4 injuries, p < 0.0002). Conclusion A larger number of persons were riding for a longer period of the year compared to previous studies in the United Kingdom. There was also a shift in the patterns of injury seen in this population over the last two to three decades.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 5","pages":"2042533313476688"},"PeriodicalIF":0.0,"publicationDate":"2013-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2042533313476688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31511640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

An identification and brief advice programme for low-risk alcohol consumption in an acute medical setting: an implementation study. 紧急医疗环境中低风险酒精消费的识别和简短咨询方案:实施研究。

JRSM short reports Pub Date : 2013-04-18 Print Date: 2013-05-01 DOI: 10.1177/2042533313476696

Susannah R Woodrow, Stuart A Green, Karen J Phekoo, Vijay Pb Grover, James Lovendoski, Mike Anderson, Owen Bowden-Jones, Matthew R Foxton

{"title":"An identification and brief advice programme for low-risk alcohol consumption in an acute medical setting: an implementation study.","authors":"Susannah R Woodrow, Stuart A Green, Karen J Phekoo, Vijay Pb Grover, James Lovendoski, Mike Anderson, Owen Bowden-Jones, Matthew R Foxton","doi":"10.1177/2042533313476696","DOIUrl":"https://doi.org/10.1177/2042533313476696","url":null,"abstract":"Objectives: To implement an identification and brief advice (IBA) intervention to detect low-risk/hazardous alcohol consumption.Design: Implementation was guided through the use of quality improvement tools and training.Setting: This study was conducted over an 18-month period from April 2010 to September 2011 on a 42-bed acute medical unit at a central London acute hospital.Participants: All medical patients over the age of 18 admitted to the acute assessment unit were eligible; any patient unable to provide a medical history either through language barriers or due to illness was excluded.Main outcome measures: Percentage of medical patients admitted each week to the acute assessment unit who were screened for low-risk/hazardous alcohol consumption.Results: Weekly data were analysed in time series run charts and cross-referenced to the date of educational sessions and their effect on the uptake of screening monitored. A demonstrable change in the mean percentage number of patients screened was observed in different time periods, 67.3-80.1%, following targeted teaching on the AAU.Conclusions: Our study demonstrates the successful use of quality improvement methodology to guide the implementation of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), an IBA intervention, in the acute medical setting. The incorporation of the AUDIT-C into an admission document has been well accepted by the junior doctors, attaining an average (mean) of 80% of patients being screened using the tool. Targeted teaching of clinical staff involved in admitting patients appears to be the most effective method in improving uptake of IBA by junior doctors.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 5","pages":"2042533313476696"},"PeriodicalIF":0.0,"publicationDate":"2013-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2042533313476696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31511641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The first five years: a mixed methods study investigating reflections on working as a hospital consultant. 前五年:一项混合方法研究，调查作为医院顾问工作的感想。

JRSM short reports Pub Date : 2013-04-18 Print Date: 2013-05-01 DOI: 10.1177/2042533313476686

Jeremy M Brown, Nigel J Shaw, David R Graham

{"title":"The first five years: a mixed methods study investigating reflections on working as a hospital consultant.","authors":"Jeremy M Brown, Nigel J Shaw, David R Graham","doi":"10.1177/2042533313476686","DOIUrl":"https://doi.org/10.1177/2042533313476686","url":null,"abstract":"Objectives This paper revisits the same cohort of hospital consultants approximately five years after they were first appointed to investigate their reflections on establishing themselves in their role. Design Mixed methods using a short survey and in-depth semistructured interviews. Setting The study was conducted within one Deanery in the North of England. Participants The same 45 hospital consultants who were invited to participate in the study in 2007 were asked to take part in the second stage of the project in February 2011. These 45 consultants started their appointments no earlier than May 2006 within 12 National Health Service (NHS) Trusts in one Deanery. A total of 16 consultants participated. Six consultants who took part in semistructured interviews in 2007–2008 were invited to be interviewed again. Four consented and participated in a further interview in 2011. Main outcome measures Do consultants feel they have completed their transition into their senior clinical posts? Yes, although the ever changing nature of the consultant role means new challenges are always having to be being addressed. What support mechanisms are valued by consultants? Informal support mechanisms are greatly valued by consultants and these are built up over time. Are consultants satisfied that they made the correct specialty choice? Yes, all respondents reported satisfaction in their specialty choice. Results After reflecting on five years in post, all agreed that Specialist training prepared them well for the clinical aspects of their role. Ten (62%) felt they were not prepared for dealing with Trust Management issues and 13 (81%) felt unprepared for financial management. Conclusions consultants learn on the job and eventually fulfil their potential in the role over time. However, the role is regularly changing so informal support mechanisms are valued to help deal with a highly complex role.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 5","pages":"2042533313476686"},"PeriodicalIF":0.0,"publicationDate":"2013-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2042533313476686","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31511639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

From gold-medal glory to prohibition: the early evolution of cocaine in the United Kingdom and the United States. 从金牌荣耀到禁令：可卡因在英国和美国的早期演变。

JRSM short reports Pub Date : 2013-04-18 Print Date: 2013-05-01 DOI: 10.1177/2042533313478324

Vicki Wielenga, Dawna Gilchrist

{"title":"From gold-medal glory to prohibition: the early evolution of cocaine in the United Kingdom and the United States.","authors":"Vicki Wielenga, Dawna Gilchrist","doi":"10.1177/2042533313478324","DOIUrl":"10.1177/2042533313478324","url":null,"abstract":"As reported in the 2011 World Drug Report, cocaine is likely to be the most problematic drug worldwide in terms of trafficking-related violence and second only to heroin in terms of negative health consequences and drug deaths. Over a period of 60 years, cocaine evolved from the celebrated panacea of the 1860s to outlawed street drug of the 1920s. As demonstrated by the evolution of cocaine use and abuse in the United Kingdom and United States during this time period, cultural attitudes influenced both the acceptance of cocaine into the medical field and the reaction to the harmful effects of cocaine. Our review of articles on cocaine use in the United Kingdom and the United States from 1860 to 1920 reveals an attitude of caution in the United Kingdom compared with an attitude of progressivism in the United States. When the trends in medical literature are viewed in the context of the development of drug regulations, our analysis provides insight into the relationship between cultural attitudes and drug policy, supporting the premise that it is cultural and social factors which shape drug policy, rather than drug regulations changing culture.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 5","pages":"2042533313478324"},"PeriodicalIF":0.0,"publicationDate":"2013-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31511642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Omental necrosis masquerading as urinary retention following laparoscopic Roux en Y gastric bypass for super obesity. 超级肥胖症腹腔镜 Roux en Y 胃旁路术后伪装成尿潴留的网膜坏死。

JRSM short reports Pub Date : 2013-04-10 Print Date: 2013-05-01 DOI: 10.1177/2042533312472127

S Lammy, J Kynaston, A Mitchell, D Bruce

引用次数: 0

The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation. 在线诊断决策支持系统（伊莎贝尔）在全科实践中的实用性：过程评估。

JRSM short reports Pub Date : 2013-04-04 Print Date: 2013-05-01 DOI: 10.1177/2042533313476691

Emily J Henderson, Greg P Rubin

{"title":"The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation.","authors":"Emily J Henderson, Greg P Rubin","doi":"10.1177/2042533313476691","DOIUrl":"10.1177/2042533313476691","url":null,"abstract":"Objectives: To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting.Design: Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice.Setting: The system was introduced by NHS County Durham and Darlington in the UK in selected general practices as a three-month pilot.Participants: General practitioners and nurse practitioners who had access to Isabel as part of the Primary Care Trust's pilot.Main outcome measures: General practitioners' views, experiences and usage of the system.Results: Seven general practices agreed to pilot Isabel. Two practices did not subsequently use it. The remaining five practices conducted searches on 16 patients. Post-use surveys (n = 10) indicated that Isabel had little impact on diagnostic decision-making. Focus group participants stated that, although the diagnoses produced by Isabel in general did not have an impact on their decision-making, they would find the tool useful if it were better tailored to the primary care setting. Our analysis concluded that normalization was not likely to occur in its current form.Conclusions: Isabel was of limited utility in this short pilot study and may need further modification for use in general practice.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 5","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2013-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/12/10.1177_2042533313476691.PMC3681231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31511637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unilateral sino-nasal haemorrhagic polyp masquerading as a malignancy in a boxer. 拳击手单侧鼻中出血息肉伪装成恶性肿瘤。

JRSM short reports Pub Date : 2013-04-01 Epub Date: 2013-03-25 DOI: 10.1177/2042533313476698

Ashwin Algudkar, Ricardo Persaud, Michail Chatzimichalis, Abhijeet Parikh

引用次数: 1

A rare but important cause of chest pain. 一种罕见但重要的胸痛病因。

JRSM short reports Pub Date : 2013-04-01 Epub Date: 2013-03-25 DOI: 10.1258/shorts.2012.012053

Ella Ferdinand, Samuel Adjepong, John I W Jones, Jeffrey M Bateman, Adam D Farmer

引用次数: 0

Acute psychosis caused by hypothyroidism following radioactive iodine treatment of Graves' disease. 放射性碘治疗Graves病后甲状腺功能减退所致急性精神病。

JRSM short reports Pub Date : 2013-04-01 Epub Date: 2013-03-25 DOI: 10.1177/2042533313476858

Catherine Hyams, Pavan Joshi, Paul Foster, Jonathan Katz

引用次数: 9