Associations Between Telemedicine Use Barriers, Organizational Factors, and Physician Perceptions of Care Quality.

Evaluating physician perceptions of telemedicine use and its impact on care quality among physician providers is critical to sustaining telemedicine programs, given the uncertainty of reimbursement policy, preferences, inadequate training, and technical difficulties. Physicians reported technical barriers to effectively practicing integrated medicine using telemedicine as patient volumes increased during the pandemic. The objective of this work was to examine whether perceived practice barriers and facilitators were associated with physician respondents' perceptions of telemedicine care quality compared with in-person care.

Similarities and Differences in Diabetes Diagnosis Stories Among Adults With Type 1 or Type 2 Diabetes in Appalachian Ohio.

This qualitative study examined adults' recollections of their reactions to their diabetes diagnosis and explored the similarities and differences among those diagnosed with type 1 versus type 2 diabetes. Based on semistructured interviews, the authors identified three themes: ) shared emotional reactions of fear, sadness, confusion, and worry; ) perceived differences in expressing concerns for diabetes complications; and ) differences in perceiving the diagnosis as a surprise versus an inevitability. How health care professionals (HCPs) deliver diabetes diagnoses may be crucial to individuals' acceptance of the condition and coping strategies.

The relationship between clinical presentation and the nature of care in adults with intellectual disability and epilepsy - national comparative cohort study.

Background: A quarter of People with Intellectual Disabilities (PwID) have epilepsy compared with 1% of the general population. Epilepsy in PwID is a bellwether for premature mortality, multimorbidity and polypharmacy. This group depends on their care provider to give relevant information for management, especially epilepsy.

Evaluating the Translational Potential of Bacteriocins as an Alternative Treatment for Infections in Animals and Humans.

Antibiotic resistance remains a global threat to human and animal health. is an opportunistic pathogen that causes minor to life-threatening infections. The widespread use of antibiotics in the clinical, veterinary, and agricultural setting combined with the increasing prevalence of antibiotic-resistant strains makes it abundantly clear that alternatives to antibiotics are urgently needed.

The impact of university STEM assets: A systematic review of the empirical evidence.

Background: Innovation ecosystems are an important driver of regional economic growth and development. STEM assets connected to universities may play an important role in such ecosystems.

Objective: To systematically review the literature relating to the effect of university STEM assets on regional economies and innovation ecosystems, providing a better understanding of how the impact is generated and constrained, as well as identifying any gaps in knowledge.

Trust-building vs. "just trust me": reflexivity and resonance in ethnography.

Amidst a perceived credibility crisis, recent scholarship has challenged basic norms of how ethnographies are conducted. This article identifies, underlying these critiques, a "trust me" fallacy that misunderstands ethnography as requiring blind trust in the researcher, leading to proposed reforms that promote extractive research practices by treating truths as raw commodities to be traded in for credibility. We argue such practices are unlikely to resolve critics' concerns, and at the same time, they challenge the ethnographic capacity for resonance.

Temperature Effects on the Survival and Development of Two Pest Bark Beetles Hylurgus ligniperda F. (Coleoptera: Curculionidae) and Hylastes ater Paykull (Coleoptera: Curculionidae).

Hylurgus ligniperda (F.) and Hylastes ater (Paykull) are secondary bark beetles that have successfully spread beyond their native range, particularly into Pinus spp. plantations in the Southern Hemisphere.

The Role of Psychologists in Pediatric Hospital Medicine.

The authors review the multiple roles of the pediatric psychologist in hospital medicine practice, which is commonly referred to as pediatric consultation-liaison (CL) psychology. A brief history of development of training of CL psychologists is discussed as well as current models of practice. The authors describe specific populations that CL psychologists assist in managing when hospitalized as well as how the CL psychologist can contribute to health care systems and public policy advocacy.

The Impact of Incorporating Multiple Best Practices on Live Outcomes for a Municipal Animal Shelter in Memphis, TN.

Modern animal shelters are encouraged to adopt "best practices" intended to promote life-saving for the animals that enter their systems. While these best practices have been defined and widely promoted within the profession, few studies have tracked how making the recommended changes affects live release rates (LRR) and other shelter metrics. In 2017, the municipal animal shelter in Memphis, TN (Memphis Animal Services) implemented five new strategies and analyzed their resultant life-saving data.

Paramedic rhythm interpretation misclassification is associated with poor survival from out-of-hospital cardiac arrest.

Background: Early recognition and rapid defibrillation of shockable rhythms is strongly associated with survival in out of hospital cardiac arrest (OHCA). Little is known about the accuracy of paramedic rhythm interpretation and its impact on survival. We hypothesized that inaccurate paramedic interpretation of initial rhythm would be associated with worse survival.

Intramuscular adrenaline for out-of-hospital cardiac arrest is associated with faster drug delivery: A feasibility study.

Background: Early adrenaline administration is associated with return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA). Animal data demonstrate a similar rate of ROSC when early intramuscular (IM) adrenaline is given compared to early intravenous (IV) adrenaline.

Aim: To evaluate the feasibility of protocolized first-dose IM adrenaline in OHCA and it's effect on time from Public Safety Access Point (PSAP) call receipt to adrenaline administration when compared to IO and IV administration.

Emergency physician perspectives on initiating buprenorphine/naloxone in the emergency department: A qualitative study.

Objectives: The objective of this study was to examine the perspectives of Canadian emergency physicians on the care of patients with opioid use disorders in the emergency department (ED), in particular the real-world facilitators to prescribing buprenorphine/naloxone (BUP) in the ED.

Methods: We conducted semistructured qualitative interviews using a multi-site-focused ethnographic design. Purposive sampling via an existing national research network was used to recruit ED physicians.

A 3-year-old boy with rapid obstructive symptoms secondary to coin ingestion and gastric impaction.

Foreign body ingestion is a common problem in children; blunt objects occur most frequently, and coins are the most common culprit. Rarely does coin ingestion lead to serious consequences other than esophageal impaction. In this report, we present the case of a healthy 3-year-old boy who developed rapid obstructive symptoms after the ingestion of a coin that required endoscopic retrieval from the stomach.

Impact of a financial incentive on the completion of educational metrics.

Background: The Accreditation Council for Graduate Medical Education (ACGME) requires all emergency medicine (EM) training programs to evaluate resident performance and also requires core faculty to attend didactic conference. Assuring faculty participation in these activities can be challenging. Previously, our institution did not have a formal tracking program nor financial incentive for participation in these activities.

Therapeutic Inhaled Sphingosine for Treating Lung Infection in a Mouse Model of Critical Illness.

Background/aims: Sphingosine, a sphingoid long chain base, is a natural lipid with antimicrobial properties. Recent animal studies have shown that preventive sphingosine inhalation can rescue susceptible mice, such as cystic fibrosis-, burn injured- or aged mice from bacterial pulmonary infection. While preventing lung infections in susceptible patients has obvious clinical merit, treatment strategies for an established infection are also direly needed, particularly in the times of rising antibiotic resistance.

Emergency department extracorporeal membrane oxygenation as a rescue therapy for ventricular tachycardia electrical storm: a case report.

Arrhythmogenic right ventricular cardiomyopathy is a cause of sudden cardiac death in often otherwise healthy young adults. Cardiac arrest following an unstable tachydysrhythmia may be the primary presenting symptom. Venous arterial extracorporeal life support via extracorporeal membrane oxygenation (VA ECMO) has been used as a rescue strategy in emergency departments (EDs) for patients with cardiac arrest unresponsive to conventional cardiopulmonary resuscitation.

Dedicated emergency department physical therapy is associated with reduced imaging, opioid administration, and length of stay: A prospective observational study.

Background: Emergency department based Physical Therapy (ED-PT) has been practiced globally in various forms for over 20 years and is an emerging resource in the US. While there is a growing body of evidence suggesting that ED-PT has a positive effect on a number of clinical and operational outcomes in patients presenting with musculoskeletal (MSK) pain, there are few published narratives that quantify this in the US. Although there are international papers that offer outcome data on reduction of pain, imaging, throughput time, and the ability of physical therapists to appropriately manage MSK conditions in the ED setting, most papers to date have been descriptive in nature.

Emergencies and Equivocality Under the Inherent Jurisdiction: A Local Authority v BF [2018] EWCA CIV 2962 and Southend-On-Sea Borough Council v Meyers [2019] EWHC 399 (FAM).

In A Local Authority v BF [2018] EWCA Civ 2962, the Court of Appeal refused to grant permission to appeal against an interim judgment that deprived a capacitous man, Mr Meyers, of his liberty. The deprivation of liberty was held to be justified on the basis that there was evidence suggesting that he was of unsound mind under Article 5(1)(e) of the European Convention on Human Rights and, in any event, it was an emergency which temporarily obviated the need to establish that he was of unsound mind. In this commentary, I argue that the decision was flawed in two respects.

Awareness as a dimension of health care access: exploring the case of rural palliative care provision in Canada.

Objectives: In Canada, the rural elderly population is increasing in size, as is their need for palliative care services in these settings. This analysis aims to identify awareness-associated barriers to delivering rural palliative care services, along with suggestions for improving service delivery from the perspective of local health care providers.

Methods: A total of 40 semi-structured interviews with various formal and informal health care providers were conducted in four rural and/or remote Canadian communities with limited palliative care resources.

Amitriptyline Reduces Inflammation and Mortality in a Murine Model of Sepsis.

Background/aims: During sepsis, an unchecked pro-inflammatory response can be detrimental to the host. We investigated the potential protective effect of amitriptyline (AT).

Methods: We used two murine models of sepsis: Cecal ligation and puncture and endotoxemia following LPS challenge.

Principles, practice, and policy vacuums: Policy actor views on provincial/territorial harm reduction policy in Canada.

Introduction: Canada is experiencing a new era of harm reduction policymaking and investment. While many provinces and territories are expanding access to these services, harm reduction policy and policymaking varies across the country. The present study, part of the Canadian Harm Reduction Policy Project (CHARPP), described policy actors' views on formal harm reduction policies in Canada's 13 provinces and territories.

Lower Extremity Duplex Ultrasound Screening Protocol for Moderate- and High-Risk Trauma Patients.

Background: Deep vein thrombosis (DVT) remains a significant cause of morbidity after injury. Lower extremity duplex ultrasound screening (LEDUS) is designed to identify early, asymptomatic DVTs in moderate and high risk patients. We sought to describe when thrombus is detected and identify which trauma patients benefit from LEDUS.