Review article: Goals-of-care discussions for adult patients nearing end of life in emergency departments: A systematic review.

Goals-of-care discussions at end-of-life are associated with increased patient satisfaction and reduced treatment burdens, reduced family and healthcare worker distress and healthcare costs, while achieving equal life-expectancy. It is unclear how goals-of-care discussions should occur. The objective of the study was to determine which patients could benefit, requirements, content, documentation, and harms and benefits of emergency medicine goals-of-care discussions.

Medical perspectives regarding goals-of-care consultations in Emergency Departments.

Goals-of-care discussions aim to establish patient values for shared medical decision-making. These discussions are relevant towards end-of-life as patients may receive non-beneficial treatments if they have never discussed preferences for care. End-of-life care is provided in Emergency Departments (EDs) but little is known regarding ED-led goals-of-care discussions.

Testing a new form to document 'Goals-of-Care' discussions regarding plans for end-of-life care for patients in an Australian emergency department.

Objective: There is limited literature to inform the content and format of Goals-of-Care forms, for use by doctors when they are undertaking these important conversations.

Methods: This was a prospective, qualitative and quantitative study evaluating the utility of a new 'Goals-of-Care' form to doctors in a private, tertiary ED, used from December 2016 to February 2017 at Cabrini, Melbourne. A Goals-of-Care form was designed, incorporating medical aims of therapy and patient values and preferences.

Emergency consultants value medical scribes and most prefer to work with them, a few would rather not: a qualitative Australian study.

Objective: The utilisation of medical scribes in the USA has enabled productivity gains for emergency consultants, though their personal experiences have not been widely documented. We aimed to evaluate the consultant experience of working with scribes in an Australian ED.

Methods: Emergency consultants working with scribes and those who declined to work with scribes were invited to participate in individual interviews (structured and semistructured questions) about scribes, scribe work and the scribe program in October 2016.

The 9-Item Physician Documentation Quality Instrument (PDQI-9) score is not useful in evaluating EMR (scribe) note quality in Emergency Medicine.

Background: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine.

An economic evaluation of the costs of training a medical scribe to work in Emergency Medicine.

Objective: To undertake a cost analysis of training medical scribes in an ED.

Methods: This was a pilot, observational, single-centre study at Cabrini ED, Melbourne, Australia, studying the costs of initiating a scribe programme from the perspective of the hospital and Australian Health sector. Recruitment and training occurred between August 2015 and February 2016 and comprised of a prework course (1 month), prework training sessions and clinical training shifts for scribe trainees (2-4 months, one shift per week) who were trained by emergency physicians.

Medical scribes in emergency medicine produce financially significant productivity gains for some, but not all emergency physicians.

Objective: The present study aims to determine if a scribe in an Australian ED can assist emergency physicians to work with increased productivity and to investigate when and where to allocate a scribe and to whom.

Methods: This was a prospective observational single-centre study conducted at a private ED in Melbourne. It evaluated one American scribe and five doctors over 6 months.

The ancient drug salicylate directly activates AMP-activated protein kinase.

Salicylate, a plant product, has been in medicinal use since ancient times. More recently, it has been replaced by synthetic derivatives such as aspirin and salsalate, both of which are rapidly broken down to salicylate in vivo. At concentrations reached in plasma after administration of salsalate or of aspirin at high doses, salicylate activates adenosine monophosphate-activated protein kinase (AMPK), a central regulator of cell growth and metabolism.

Arsenic-induced SUMO-dependent recruitment of RNF4 into PML nuclear bodies.

In acute promyelocytic leukemia (APL), the promyelocytic leukemia (PML) protein is fused to the retinoic acid receptor alpha (RAR). Arsenic is an effective treatment for this disease as it induces SUMO-dependent ubiquitin-mediated proteasomal degradation of the PML-RAR fusion protein. Here we analyze the nuclear trafficking dynamics of PML and its SUMO-dependent ubiquitin E3 ligase, RNF4 in response to arsenic.

Accuracy of electrocardiogram interpretation improves with emergency medicine training.

Objective: To assess whether electrocardiogram (ECG) interpretation accuracy improves with advancing years of emergency medicine training.

Methods: A prospective cross-sectional double-blinded study of emergency medicine trainees attending teaching sessions in ACEM accredited Victorian hospitals. Subjects completed a survey about level of training, rotations completed and ECG training.

Timed Up and Go test is not useful as a discharge risk screening tool.

Objective: To determine whether the 'Timed Up and Go' (TUG) test is a useful test for predicting re-attendance at an ED, emergency hospital admission or death within 90 days in elderly patients discharged from the ED.

Methods: This was a prospective blinded cohort study at a tertiary referral ED. Patients completed a TUG test during their Allied Health assessment prior to discharge from the department.