JRSM short reports最新文献_第9页

Foundation doctors' experience of their training: a questionnaire study. 预科医生的培训经历：一项问卷调查研究。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-14 DOI: 10.1258/shorts.2012.012095

Benjamin J F Dean, Philip Michael Duggleby

{"title":"Foundation doctors' experience of their training: a questionnaire study.","authors":"Benjamin J F Dean, Philip Michael Duggleby","doi":"10.1258/shorts.2012.012095","DOIUrl":"10.1258/shorts.2012.012095","url":null,"abstract":"Objectives: We set out to evaluate the impact of Foundation Year (FY) training on the doctors who had been through this training system.Design: Doctors in training were surveyed using a structured web-based questionnaire.Setting: Postgraduate training in the UK has been the subject of much upheaval in recent years.Participants: A total of 1065 doctors in training were surveyed in late 2011 and early 2012, of which 638 were current FY doctors.Main outcome measures: The survey was both quantitative and qualitative, focusing on selection, working hours, training quality, training assessments and the regulation of training.Results: A MAJORITY OF CURRENT FY TRAINEES WORKED EXTRA WEEKLY HOURS WITH THE BREAKDOWN BEING: 5-10 hrs (54%), 10-15 hrs (17%), >15 hrs (9%) and no extra weekly hours (20%). All current FY trainees wanted to work for more than 40 h a week with the following breakdown of desired hours: per week 40-48 (22%), 48-60 (50%) and 60-70 h (19%). The average hours per week spent clerking emergency admissions by current FY trainees were as follows: zero hours (11%), 0-5 h (37%), 5-10 h (30%), 10-15 h (11%) and greater (11%). A large majority (90%) felt that it was possible for incompetent trainees to obtain satisfactory results from assessments and that the FY training program was poor at identifying failing trainees. There were high levels of dissatisfaction with the selection process.Conclusions: FY training appears to be failing in several key areas with the lack of emergency exposure a particular area of concern. It is essential that any future reforms of training address these problem areas.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/a6/SHORTS-12-095.PMC3572662.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31241502","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

The role of genetic testing in management of hereditary chronic pancreatitis. 基因检测在遗传性慢性胰腺炎治疗中的作用。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-18 DOI: 10.1258/shorts.2012.012071

Nicholas Faure Walker, Oliver J Warren, Lynsey Gawn, Long R Jiao

引用次数: 0

How to apply the results of a research paper on diagnosis to your patient. 如何将研究论文的诊断结果应用到你的病人身上。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-14 DOI: 10.1258/shorts.2012.012089

Penny Whiting, Richard M Martin, Yoav Ben-Shlomo, David Gunnell, Jonathan A C Sterne

引用次数: 14

Views on the nature of chronic fatigue syndrome: content analysis. 慢性疲劳综合征的性质:内容分析。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-14 DOI: 10.1258/shorts.2012.012051

Zahra Hossenbaccus, Peter D White

{"title":"Views on the nature of chronic fatigue syndrome: content analysis.","authors":"Zahra Hossenbaccus, Peter D White","doi":"10.1258/shorts.2012.012051","DOIUrl":"https://doi.org/10.1258/shorts.2012.012051","url":null,"abstract":"Objectives: Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), has provoked much controversy and led to arguments between the medical profession and patient organizations. A particular focus for debate is the categorization of the condition as physical or psychological in its nature. The aim of this study was to compare how the written media, patient organizations and medical authorities regard the illness.Design: Content analysis of newspaper articles, ME patient organization websites, and medical websites and textbooks were assessed by two independent assessors.Setting: Three national UK newspapers, UK ME websites, and UK medical websites and textbooks, were accessed during 2010.Participants: 146 source files were scored from 36 patients' organizations, 72 media articles and 38 medical authorities.Main outcome measured: The overall opinion of an article or website was rated using a five point Likert scale, from 'extremely psychological' (scored as 1), 'moderately psychological' (2), 'both psychological and physical' (3), 'moderately physical' (4) or 'extremely physical' (5).Results: Eighty-nine percent (32 of 36) of ME patient organizations considered the illness to be physical, compared with 58% (42/72) of newspaper articles, and 24% (9/38) of medical authorities. Sixty-three percent (24/38) of medical authorities regarded the illness as both physical and psychological. The inter-group differences of the Likert scores were statistically significant (χ(2) = 27.37, 2 df, P < 0.001).Conclusion: The considerable disagreement, particularly between ME patient organizations and medical authorities, may help to explain the gulf in understanding between doctors and patients and the consequent reluctance of some patients to engage in behavioural treatments.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/shorts.2012.012051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31241501","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: 25

Retrospective analysis of outcome of women with breast or gynaecological cancer in the intensive care unit. 重症监护室乳腺癌或妇科癌症患者预后的回顾性分析。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-14 DOI: 10.1258/shorts.2012.012036

Marlies Ostermann, Mario Raimundo, Anna Williams, Craig Whiteley, Richard Beale

{"title":"Retrospective analysis of outcome of women with breast or gynaecological cancer in the intensive care unit.","authors":"Marlies Ostermann, Mario Raimundo, Anna Williams, Craig Whiteley, Richard Beale","doi":"10.1258/shorts.2012.012036","DOIUrl":"https://doi.org/10.1258/shorts.2012.012036","url":null,"abstract":"Objectives: Advances in oncological care have led to improved short and long-term outcomes of female patients with breast and gynecological cancer but little is known about their prognosis when admitted to the intensive care unit (ICU). Our aim was to describe the epidemiology of patients with women's cancer in ICU.Design: Retrospective analysis of data of patients with breast and gynecological cancer in ICU between February 2004 and July 2008.Setting: ICU in a tertiary referral centre in London.Participants: Nineteen critically ill women with breast or gynaecological cancer.Main outcome measures: ICU and six-month outcome.Results: Eleven women had breast cancer and eight patients had gynaecological cancer. Twelve patients were known to have metastatic disease. The main reasons for admission to ICU were sepsis (94.7%), respiratory failure (36.8%) and need for vasoactive support (26.3%). ICU mortality was 31.6%. There was no difference in age and Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) score on admission to ICU between ICU survivors and non-survivors. During their stay in ICU, non-survivors had significantly more organ failure. Six-month mortality was 68.4%. Four patients had >1 admission to ICU.Conclusions: ICU outcome of critically ill women with breast or gynaecological cancer was similar to that of other non-cancer patient cohorts but six-month mortality was significantly higher. The decision to admit patients with women's cancer to the ICU should depend on the severity of the acute illness rather than factors related to the underlying malignancy. More research is needed to explore the outcome of patients with women's cancer after discharge from ICU.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/shorts.2012.012036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31241499","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: 13

Requesting radiological investigations - do junior doctors know their patients? A cross-sectional survey. 要求进行放射检查——初级医生了解他们的病人吗?横断面调查。

JRSM short reports Pub Date : 2013-01-01 Epub Date: 2013-01-14 DOI: 10.1258/shorts.2012.012043

Dc Bosanquet, Js Cho, N Williams, D Gower, K Gower Thomas, Mh Lewis

{"title":"Requesting radiological investigations - do junior doctors know their patients? A cross-sectional survey.","authors":"Dc Bosanquet, Js Cho, N Williams, D Gower, K Gower Thomas, Mh Lewis","doi":"10.1258/shorts.2012.012043","DOIUrl":"https://doi.org/10.1258/shorts.2012.012043","url":null,"abstract":"Objectives: To ascertain clinicians' knowledge of their patients when requesting radiological investigations, as required legally by UK government legislation 'Ionising Radiation (Medical Exposure) Regulations 2000' (IRMER 2000), following the implementation of European Working Time Directive.Design: Cross sectional survey.Participants: All doctors requesting radiological requests every Monday, following the weekend on-call, over an 8-week period. There were no exclusion criteria.Main outcome measures: Baseline data analysis, including grade and specialty of requesting doctor, types of modality requested, knowledge of their patient, addressograph signature confirming identity and appropriateness of investigation.Results: 164 requests were received, the majority (61%) were made by Foundation Programme 1 (FP1) doctors and general medical specialties accounted for the highest proportion of requests (45%). Ultrasound scanning was the most frequently requested investigation (47%), closely followed by computed tomography (CT) scans (42%). Almost a third (30%) of requests were made by doctors who had not seen the patient to be investigated, predominantly by FP1 doctors (p=0.003) and more frequently by general medical specialties (p=0.001). Signatures were absent on 20% of the addressographs and overall, 10% of requests were deemed inappropriate.Conclusions: In almost a third of radiological requests, doctors have not seen patients to be investigated, most likely as a result of shift working patterns. This does not fulfil the IRMER 2000 criteria and potentially exposes patients to unnecessary and inappropriate radiation.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"4 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/shorts.2012.012043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31241500","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: 16

Introduction of Sprotte needles to a single-centre acute neurology service: before and after study. 在单一中心急性神经病学服务中引入注射针:研究前后。

JRSM short reports Pub Date : 2012-12-01 Epub Date: 2012-12-15 DOI: 10.1258/shorts.2012.012090

Vejay N Vakharia, Hazel Lote

{"title":"Introduction of Sprotte needles to a single-centre acute neurology service: before and after study.","authors":"Vejay N Vakharia, Hazel Lote","doi":"10.1258/shorts.2012.012090","DOIUrl":"https://doi.org/10.1258/shorts.2012.012090","url":null,"abstract":"Objectives: To introduce atraumatic (Sprotte) lumbar puncture needles and compare complication rates with traumatic (Quincke) needles.Design: Complication rates associated with traumatic needle use were retrospectively analysed over a four-week period. Atraumatic needles were then implemented and a prospective analysis of the complication rates was undertaken for a further six weeks.Setting: A single-centre acute neurology unit in a London teaching hospital.Participants: Traumatic needles (n = 24 patients); atraumatic needles (n = 36 patients).Main outcome measures: Headache rates, use of over-the-counter medications, further medical assistance, time off work, nausea and vomiting, traumatic taps (as per the count of red blood cells per millilitre in the first sample of cerebrospinal fluid [CSF]) and back pain.Results: A comparison of traumatic and atraumatic needles revealed a significant reduction in the incidence of post-lumbar puncture headaches (*P < 0.01), headaches requiring over-the-counter medication (*P < 0.00001), need for further medical assistance (*P < 0.006), time off work (*P < 0.003), nausea and vomiting (*P < 0.01) and traumatic taps as per the count of red blood cells per millilitre in the first sample of CSF (*P < 0.02). There was no significant difference in the incidence of back pain (P > 0.05).Conclusions: Most complication outcomes are significantly lower with the use of atraumatic lumbar puncture needles. We present for the first time in the literature that the rate of 'traumatic taps' are significantly lower with atraumatic needles. The implementation of atraumatic needles in an acute neurology service is safe and produces reliable, reproducible results in keeping with previously published randomized controlled trials.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"3 12","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/shorts.2012.012090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31293880","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: 10

Effect of an environmental health educational programme for paediatricians in an Egyptian University Hospital: before and after study. 埃及一所大学医院儿科医生环境健康教育计划的效果：前后研究。

JRSM short reports Pub Date : 2012-12-01 Epub Date: 2012-12-31 DOI: 10.1258/shorts.2012.012093

Reem A Abbas, Ashgan A Alghobashy

{"title":"Effect of an environmental health educational programme for paediatricians in an Egyptian University Hospital: before and after study.","authors":"Reem A Abbas, Ashgan A Alghobashy","doi":"10.1258/shorts.2012.012093","DOIUrl":"10.1258/shorts.2012.012093","url":null,"abstract":"Objectives: To study the effect of an educational intervention on paediatricians' knowledge, attitudes and practices regarding children's environmental health and to identify the sources of information and common environmental history taking constrains.Design: Before and after study.Setting: Zagazig University Paediatric Hospital.Participants: Practising paediatricians from all specialty units.Main outcome measures: The outcome of a specifically designed educational programme about paediatric environmental health was assessed using structured pre- and post-test questionnaires.Results: Nearly half the participants were aware about most of the paediatric environmental health-related topics. Textbooks/guidelines (85.7%) and the Internet (64.3%) were the main sources of information. The participants demonstrated relatively strong positive attitudes towards the importance of children's environmental health. However, less than half of them (44.6%) reported environmental history taking as a routine practice; where lack of time (94.6%), wide range of hazardous exposures (91.1%) and lack of expertise and training (91.1%) were the main constrains. Significant improvement in participants' knowledge, attitudes and practices was revealed after the educational programme.Conclusions: There is a demand for continuous medical education about environmental health in paediatric practice, particularly environmental and occupational history taking.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"3 12","pages":"86"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/67/SHORTS-12-093.PMC3545340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31293883","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

A cross-sectional study of aggression levels in physicians and orthopaedic surgeons: impact on specialty selection and training? 内科医生和骨科医生攻击性水平的横断面研究:对专业选择和培训的影响?

JRSM short reports Pub Date : 2012-12-01 Epub Date: 2012-12-15 DOI: 10.1258/shorts.2012.012074

T Barlow, A Wight, D Barlow

{"title":"A cross-sectional study of aggression levels in physicians and orthopaedic surgeons: impact on specialty selection and training?","authors":"T Barlow, A Wight, D Barlow","doi":"10.1258/shorts.2012.012074","DOIUrl":"https://doi.org/10.1258/shorts.2012.012074","url":null,"abstract":"Objectives: To determine if current validated psychometric evaluations could determine a difference in basic behavioural characteristics between surgical and medical specialties.Design: Cross-sectional study.Setting: Two district general hospitals and one University teaching hospital in England, UK.Participants: Internal medicine (16) and trauma and orthopaedic (20) consultants.Main outcome measures: Aggression levels as assessed by the Buss and Warren questionnaire. The self-administered questionnaire assesses aggression in terms of physical, verbal, anger, hostility, indirect hostility and an overall assessment of aggression.Results: All participants had aggression scores below the population average. We found a significant difference (P < 0.01) in total level of aggression, with orthopaedic consultants scoring a mean of 61.1 (standard deviation [SD] 9.2) and physicians 51.3 (SD 9.5). When analysis of the five different subtypes of aggression was carried out, orthopaedic surgeons scored significantly higher in terms of verbal aggression (P = 0.005), hostility (P = 0.002) and indirect hostility (P = 0.03).Conclusion: This study joins a growing evidence base for aspects of behaviour indicative of a given specialty. Aggression is a relatively stable behavioural characteristic from adolescence, and as such this is the first study of its type to suggest that the differences in behavioural characteristics seen between specialties are inherent, rather than learned. It is unclear if the differences observed represent an attraction of that specialty to the personality type or is required for success within the given specialty. Whether this can be used in terms of selection into higher specialty training, or influence training within specialties, requires further work.","PeriodicalId":89182,"journal":{"name":"JRSM short reports","volume":"3 12","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/shorts.2012.012074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31293881","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: 2

The recent history of the clinical case report: a narrative review. 临床病例报告的近代史：叙事性回顾。

JRSM short reports Pub Date : 2012-12-01 Epub Date: 2012-12-31 DOI: 10.1258/shorts.2012.012046

Trygve Nissen, Rolf Wynn

引用次数: 0