Publications by authors named "J L Winning"

Objectives: This study aimed to explore the role of CT in septic patients presenting to the emergency department (ED).

Materials And Methods: We performed a retrospective secondary analysis of 192 septic patients from a prospective observational study, i.e.

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Objectives: Consensus regarding biomarkers for detection of infection-related organ dysfunction in the emergency department is lacking. We aimed to identify and validate biomarkers that could improve risk prediction for overt or incipient organ dysfunction when added to quick Sepsis-related Organ Failure Assessment (qSOFA) as a screening tool.

Design: In a large prospective multicenter cohort of adult patients presenting to the emergency department with a qSOFA score greater than or equal to 1, admission plasma levels of C-reactive protein, procalcitonin, adrenomedullin (either bioavailable adrenomedullin or midregional fragment of proadrenomedullin), proenkephalin, and dipeptidyl peptidase 3 were assessed.

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Numerous medical schools have been updating and modernising their undergraduate curricula in response to the changing health needs of today's society and the updated General Medical Council competencies required for qualification. The humanities are sometimes seen as a way of addressing both of these requirements. Medical humanities advocates would argue that the humanities have a vital role to play in undergraduate medical education, allowing students to develop the critical tools required by the 21st-century clinician to deliver the best person-centred care.

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Infectious biomarkers such as procalcitonin (PCT) can help overcome the lack of sensitivity of the quick Sequential Organ Failure Assessment (qSOFA) score for early identification of sepsis in emergency departments (EDs) and thus might be beneficial as point-of-care biomarkers in EDs. Our primary aim was to investigate the diagnostic performance of PCT for the early identification of septic patients and patients likely to develop sepsis within 96 h of admission to an ED among a prospectively selected patient population with elevated qSOFA score. In a large multi-centre prospective cohort study, we included all adult patients ( = 742) with a qSOFA score of at least 1 who presented to the ED.

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The crisis of physician burnout has been widely and repeatedly reported across the mainstream press and medical journals around the world, in the closing years of the second decade of the 21st century. Despite multiple systematic reviews and commentary on the scale of this 'global epidemic', understandings of both the phenomenon and the most effective interventions remain limited. Practice-based medical humanities represents the collaborative sharing of conceptual tools for understanding illness and clinical practice and the shouldering of responsibility for mapping the shape of care, in all its local, national and global contexts, thinking-with rather than critique on the profession and its practices.

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