Academic literature on the topic 'Department of Chief Medical Examiner'
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Journal articles on the topic "Department of Chief Medical Examiner"
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Dadeh, Ar-aishah, and Pitshaya Phunyanantakorn. "Factors Affecting Length of Stay in the Emergency Department in Patients Who Presented with Abdominal Pain." Emergency Medicine International 2020 (May 27, 2020): 1–7. http://dx.doi.org/10.1155/2020/5406516.
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Objective. We aimed to identify factors affecting length of stay in the emergency department in patients who presented with abdominal pain. Methods. A retrospective cohort study was conducted from 1 January 2017 to 31 December 2017. The medical records were reviewed from 217 patients older than 15 years with the chief complaint of abdominal pain. The patients were divided into emergency department length of stay (EDLOS) < 4 hours and ≥4 hours. The two groups were compared in terms of baseline characteristics, physical examination, time of presenting, attending physicians, interdepartmental consultations, investigations, ED disposition, final diagnosis, and mortality. The significant factors affecting longer EDLOS were examined using univariate and multivariate analyses by logistic regression. Results. Factors affecting longer EDLOS were age ≥50 (odds ratio (OR) 3.17, 95% confidence interval (CI) 1.36–7.42), interdepartmental consultation ≥2 specialists (OR 71.82, 95% CI 5.67–909.51), blood testing ≥2 rounds (OR 85.6, 95% CI 4.22–1734.6), and ultrasonography (OR 8.28, 95% CI 1.84–37.26). Conclusion. The study found that the statistically significant factors that prolonged EDLOS in patients with the chief complaint of abdominal pain were age, rounds of blood test, interdepartmental consultation, and the need for ultrasonography.
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Il'kova, Olga Petrovna, Yelena Ivanovna Ustinova, and Nikolay Nikolayevich Sal'nikov. "An improvement of medical care for children and adolescents with ocular tuberculosis in Saint-Petersburg - an important goal of city dispensary." Ophthalmology journal 7, no. 4 (December 15, 2014): 79–83. http://dx.doi.org/10.17816/ov2014479-83.
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The medical care for children with ocular tuberculosis until the end of the nineties was delivered in the Saint-Petersburg City Diagnostic Centre # 7, OLS. Under dispensary observation in the tuberculosis department, there were no less than 100 patients with hematogenous tuberculosis (in association with tuberculosis contamination or local forms of non-ocular localizations). Recently, there has been only a half time ophthalmologist in the dispensary to admit children and adolescents with ocular tuberculosis or suspected cases. Upon an initiative of phthisioophthalmology section of the Saint-Petersburg scientific medical ophthalmological society to the staff of the city dispensary ophthalmologist O.P. Il’kova was recommended and admitted, with a specialization to work as pediatric phthisioophthalmologist. During 2014, O.P. Il’kova attended to adult patients at the ophthalmology department of the dispensary, consulted adolescents in the “Drujba” tuberculosis sanatorium and analysed the treatment results of tuberculosis patients who became ill at their childhood. The phthisioophthalmology section of the Saint-Petersburg scientific medical ophthalmological society and the ophthalmology department of the Saint-Petersburg anti-tuberculosis dispensary solicit the chief executives of the dispensary to allocate ophthalmologist, nurse positions and to create necessary conditions to examine and treat children and adolescents with ocular tuberculosis or suspected cases.
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Khan, Nashid Tabassum, Palash Kumar Bose, Syed Tanjilul Haque, Sohel Mahmud, and Rezina Sultana. "Suicidal Death due to Organophosphorus Compound Poisoning ? an Experience of 67 Cases." Journal of Enam Medical College 6, no. 2 (June 21, 2016): 97–100. http://dx.doi.org/10.3329/jemc.v6i2.27765.
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Background: Bangladesh is an agro-based country. Suicide by agrochemical compounds are increasing day by day in this country. Organophosphorus compounds (OPC) are commonly used for suicide. Mostly these are used for suicidal purpose in rural areas in our country due to low cost, toxicity and availability.Objective: To find out the relationship of age and sex variation along with the causes that influenced different income group people to ingest OPC for committing suicide.Materials and Methods: This study was conducted in the Department of Forensic Medicine, Dhaka Medical College during January to December 2010. Data were collected at the time of autopsy and from postmortem examination report of viscera. Viscera were preserved and sent to the Chief Chemical Examiners Office, Dhaka for toxicological analysis.Results: In this study, middle aged subjects (2030 years) were found to commit suicide using OPC in comparison to other age groups. Among the cases male were 57% and female 43%. Poverty was found as the most common cause (20%) of OPC poisoning.Conclusion: Poverty is the leading cause of death of OPC poisoning followed by failure in love and adultery. Business failure, unhappiness in conjugal life, demand for dowry and violence against women are other causes to commit suicide by OPC.J Enam Med Col 2016; 6(2): 97-100
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Clawson, Jeff, Greg Scott, Weston Lloyd, Brett Patterson, Tracey Barron, Isabel Gardett, and Christopher Olola. "Outcome Accuracy of the Emergency Medical Dispatcher's Initial Selection of a Diabetic Problems Protocol." Prehospital and Disaster Medicine 29, no. 1 (December 10, 2013): 37–42. http://dx.doi.org/10.1017/s1049023x13008923.
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AbstractIntroductionDiabetes mellitus, although a chronic disease, also can cause acute, sudden symptoms requiring emergency intervention. In these cases, Emergency Medical Dispatchers (EMDs) must identify true diabetic complaints in order to determine the correct care. In 911 systems utilizing the Medical Priority Dispatch System (MPDS), International Academies of Emergency Dispatch-certified EMDs determine a patient's chief complaint by matching the caller's response to an initial pre-scripted question to one of 37 possible chief complaints protocols. The ability of EMDs to identify true diabetic-triggered events reported through 911 has not been studied.ObjectiveThe primary objective of this study was to determine the percentage of EMD-recorded patient cases (using the Diabetic Problems protocol in the MPDS) that were confirmed by either attending paramedics or the hospital as experiencing a diabetic-triggered event.MethodsThis was a retrospective study involving six hospitals, one fire department, and one ambulance service in Salt Lake City, Utah USA. Dispatch data for one year recorded under the Diabetic Problems protocol, along with the associated paramedic and hospital outcome data, were reviewed/analyzed. The outcome measures were: the percentage of cases that had diabetic history, percentage of EMD-identified diabetic problems cases that were confirmed by Emergency Medical Services (EMS) and/or hospital records as true diabetic-triggered events, and percentage of EMD-identified diabetic patients who also had other medical conditions. A diabetic-triggered event was defined as one in which the patient's emergency was directly caused by diabetes or its medical management. Descriptive statistics were used for categorical measures and parametric statistical methods assessed the differences between study groups, for continuous measures.ResultsThree-hundred ninety-three patient cases were assigned to the Diabetic Problems Chief Complaint protocol. Of the 367 (93.4%) patients who had a documented history of diabetes, 279 (76%) were determined to have had a diabetic-triggered event. However, only 12 (3.6%) initially assigned to this protocol did not have a confirmed history of diabetes.ConclusionsUsing the MPDS to select the Diabetic Problems Chief Complaint protocol, the EMDs correctly identified a true diabetic-triggered event the majority of the time. However, many patients had other medical conditions, which complicated the initial classification of true diabetic-triggered events. Future studies should examine the associations between the five specific Diabetic Problems Chief Complaint protocol determinant codes (triage priority levels) and severity measures, eg, blood sugar level and Glasgow Coma Score.ClawsonJ, ScottG, LloydW, PattersonB, BarronT, GardettI, OlolaC. Outcome accuracy of the Emergency Medical Dispatcher's initial selection of a Diabetic Problems Protocol. Prehosp Disaster Med. 2013:28(6):1-6.
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Cook, Sharlette, Khin Lay Maw, Sonal S. Munsiff, Paula I. Fujiwara, and Thomas R. Frieden. "Prevalence of Tuberculin Skin Test Positivity and Conversions Among Healthcare Workers in New York City During 1994 to 2001." Infection Control & Hospital Epidemiology 24, no. 11 (November 2003): 807–13. http://dx.doi.org/10.1086/502141.
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AbstractObjective:To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.Design:Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1,1994, to December 31, 2001.Participants:HCWs in high-risk and low-risk settings for occupational TB exposure.Results:Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR 5.7; CI95, 1.7–19.2;P< .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95,1.7–5.8;P< .001); OCME HCWs (OR 4.7; CI95, 2.3–9.4;P< .001), those of Asian ethnicity (OR 4.3; CI95,1.4–13.5;P< .01), and older HCWs (OR, 1.0; CI95,1.0–1.1;p< .05) were at a higher risk for conversion.Conclusions:Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.
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Rudolf, Frances, Kathryn Hollenbach, Keri L. Carstairs, and Shaun D. Carstairs. "A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department." Journal of Pediatric Pharmacology and Therapeutics 24, no. 3 (May 1, 2019): 234–37. http://dx.doi.org/10.5863/1551-6776-24.3.234.
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OBJECTIVES An increasing number of pediatric patients with psychiatric chief complaints present to emergency departments (EDs) nationwide. Many of these patients require treatment with antipsychotic medications to treat agitation. We sought to examine the use of antipsychotic medications in pediatric patients presenting to a tertiary care pediatric ED. METHODS We performed a retrospective electronic medical record review of patients presenting to a tertiary care pediatric hospital from January 2009 through February 2016 with a psychiatric chief complaint who received an antipsychotic medication in the ED. RESULTS A total of 229 patients were identified, 54.1% of whom were male. Mean age was 14.4 ± 2.6 years. Commonly administered medications included olanzapine (51.1%), aripiprazole (26.6%), haloperidol (24.0%), and risperidone (11.8%). Eighty-seven patients (38.0%) were given at least 1 intravenous or intramuscular dose of antipsychotic medication. A total of 113 patients (49.3%) received only 1 antipsychotic medication, 65 (28.4%) received 2, 30 (13.1%) received 3, and 21 (9.2%) received 4 or more antipsychotics. Median length of stay (minutes) increased significantly with increasing number of medications administered (p < 0.001). Length of stay was significantly shorter in patients given only oral medications (675.6 minutes, IQR 418–1194) compared to those given at least one intramuscular or intravenous dose (951 minutes, IQR 454–1652) (p = 0.014). CONCLUSIONS In this retrospective series, the majority of patients were treated with newer oral antipsychotics. Administration of multiple medications was associated with a significantly longer length of stay in the ED, as was parenteral administration of antipsychotics.
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Yoo, Junsang, Jeonghoon Lee, Poong-Lyul Rhee, Dong Kyung Chang, Mira Kang, Jong Soo Choi, David W. Bates, and Won Chul Cha. "Alert Override Patterns With a Medication Clinical Decision Support System in an Academic Emergency Department: Retrospective Descriptive Study." JMIR Medical Informatics 8, no. 11 (November 4, 2020): e23351. http://dx.doi.org/10.2196/23351.
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Background Physicians’ alert overriding behavior is considered to be the most important factor leading to failure of computerized provider order entry (CPOE) combined with a clinical decision support system (CDSS) in achieving its potential adverse drug events prevention effect. Previous studies on this subject have focused on specific diseases or alert types for well-defined targets and particular settings. The emergency department is an optimal environment to examine physicians’ alert overriding behaviors from a broad perspective because patients have a wider range of severity, and many receive interdisciplinary care in this environment. However, less than one-tenth of related studies have targeted this physician behavior in an emergency department setting. Objective The aim of this study was to describe alert override patterns with a commercial medication CDSS in an academic emergency department. Methods This study was conducted at a tertiary urban academic hospital in the emergency department with an annual census of 80,000 visits. We analyzed data on the patients who visited the emergency department for 18 months and the medical staff who treated them, including the prescription and CPOE alert log. We also performed descriptive analysis and logistic regression for assessing the risk factors for alert overrides. Results During the study period, 611 physicians cared for 71,546 patients with 101,186 visits. The emergency department physicians encountered 13.75 alerts during every 100 orders entered. Of the total 102,887 alerts, almost two-thirds (65,616, 63.77%) were overridden. Univariate and multivariate logistic regression analyses identified 21 statistically significant risk factors for emergency department physicians’ alert override behavior. Conclusions In this retrospective study, we described the alert override patterns with a medication CDSS in an academic emergency department. We found relatively low overrides and assessed their contributing factors, including physicians’ designation and specialty, patients’ severity and chief complaints, and alert and medication type.
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Puri, V. V., K. Dong, B. H. Rowe, S. W. Kirkland, C. Vandenberghe, G. Salvalaggio, R. Cooper, et al. "LO39: Healthcare costs among homeless and/or substance using adults presenting to the emergency department: a single centre study." CJEM 19, S1 (May 2017): S41. http://dx.doi.org/10.1017/cem.2017.101.
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Introduction: Active substance use and unstable housing are both associated with increased emergency department (ED) utilization. This study examined ED health care costs among a cohort of substance using and/or homeless adults following an index ED visit, relative to a control ED population. Methods: Consecutive patients presenting to an inner-city ED between August 2010 and November 2011 who reported unstable housing and/or who had a chief presenting complaint related to acute or chronic substance use were evaluated. Controls were enrolled in a 1:4 ratio. Participants’ health care utilization was tracked via electronic medical record for six months after the index ED visit. Costing data across all EDs in the region was obtained from Alberta Health Services and calculated to include physician billing and the cost of an ED visit excluding investigations. The cost impact of ED utilization was estimated by multiplying the derived ED cost per visit by the median number of visits with interquartile ranges (IQR) for each group during follow up. Proportions were compared using non-parametric tests. Results: From 4679 patients screened, 209 patients were enrolled (41 controls, 46 substance using, 91 unstably housed, 31 both unstably housed and substance using (UHS)). Median costs (IQR) per group over the six-month period were $0 ($0-$345.42) for control, $345.42 ($0-$1139.89) for substance using, $345.42 ($0-$1381.68) for unstably housed and $1381.68 ($690.84-$4248.67) for unstably housed and substance using patients (p<0.05). Conclusion: The intensity of excess ED costs was greatest in patients who were both unstably housed and presenting with a chief complaint related to substance use. This group had a significantly larger impact on health care expenditure relative to ED users who were not unstably housed or who presented with a substance use related complaint. Further research into how care or connection to community resources in the ED can reduce these costs is warranted.
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Vodonos, Alina, Victor Novack, Israel Waismel-Manor, Yacov Ezra, Adi Guetta, and Gal Ifergane. "Sick of news? Television news exposure, collective stressful events and headache related emergency department visits." PLOS ONE 16, no. 4 (April 8, 2021): e0249749. http://dx.doi.org/10.1371/journal.pone.0249749.
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Stress is a well-known trigger for primary headache yet its impact is difficult to demonstrate in large epidemiological studies. Israeli national TV news is often referred to as the “tribal fire”, as many Israelis watch national news coverage following terror attacks or military operations. We examined the association between exposure to television news and their content with headache related Emergency Department visits. This retrospective cohort study included data on daily Emergency Department visits with a chief complaint of headache in Soroka University Medical Center, during 2002–2012. Data on daily television news viewership ratings were obtained from the Israeli Audience Research Board and its content from Channel 2 headlines, the highest rated TV news program. To estimate the short-term effects of news rating during the evening news on the number of daily headache visits, we applied generalized linear mixed models. 16,693 Emergency Department visits were included in the analysis. An increase in five units of daily rating percentages was associated with increase in Emergency Department visits the following day, relative risk (RR) = 1.032, (95% CI 1.014–1.050). This association increased with the age of the patients; RR = 1.119, (95% CI 1.075–1.65) for older than 60-year-old, RR = 1.044 (95% CI 1.010–1.078) for ages 40–60 and RR = 1.000 (95% CI 0.977–1.023) for younger than 40-year-old. We did not find a specific content associated with ED visit for headache. Higher television news ratings were associated with increased incidence of Emergency Department headache related visits. We assume that especially among older persons, news viewership ratings provide an indirect estimate of collective stress, which acts as a headache trigger for susceptible subjects.
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Fleet, Richard P., Kim L. Lavoie, Jean-Pierre Martel, Gilles Dupuis, André Marchand, and Bernard D. Beitman. "Two-year follow-up status of emergency department patients with chest pain: Was it panic disorder?" CJEM 5, no. 04 (July 2003): 247–54. http://dx.doi.org/10.1017/s1481803500008447.
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ABSTRACT Objectives: We previously reported that 25% (108/441) of consecutive patients presenting to the emergency department (ED) of the Montreal Heart Institute with a chief complaint of chest pain suffered from panic disorder (PD). The purpose of the present study was to re-examine these patients (with and without PD) 2 years after their initial ED visit to determine their psychiatric and psychosocial status. Methods: An interviewer, who was kept blind to patients’ initial medical and psychiatric diagnoses, attempted to contact all patients who participated in the initial study by phone. Patients who completed the phone interview were sent a battery of psychological questionnaires by mail. Results: A total of 301 (70%) patients completed the phone interview, and 228 (52%) patients completed the self-report questionnaires. Participants and non-participants did not differ with respect to age, gender, initial self-report scores, or initial cardiac or psychiatric diagnoses. At follow-up, significantly (p < 0.05) more PD+ than non-PD (PD–) patients reported: 1) chest pains in the last month (57% vs. 31%); 2) one or more ED consultations in the past year for chest pain (40% vs. 14%); 3) one or more hospitalizations in the past year (31% vs. 11%); and 4) perceiving their general health as “poor” (22% vs. 9%). PD+ patients displayed a significant (p < 0.05) worsening of their panic symptoms, agoraphobic avoidance, depression, and trait anxiety, and reported significantly (p < 0.05) greater suicidal ideation compared to PD– patients (32% vs. 9%). Of all PD+ patients, only 22% (18/82) reported receiving some form of mental health treatment for their symptoms. Conclusions: Unrecognized and untreated PD has a chronic and disabling course. Greater efforts should be made to screen for PD in patients complaining of chest pain in EDs.
Dissertations / Theses on the topic "Department of Chief Medical Examiner"
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Herrin, Amy Elizabeth. "Assessing, Modifying, and Combining Data Fields from the Virginia Office of the Chief Medical Examiner (OCME) Dataset and the Virginia Department of Forensic Science (DFS) Datasets in Order to Compare Concentrations of Selected Drugs." VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/1057.
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The Medical Examiner of Virginia (ME) dataset and the Virginia Department of Forensic Science Driving Under the Influence of Drugs (DUI) datasets were used to determine whether people have the potential to develop tolerances to diphenhydramine, cocaine, oxycodone, hydrocodone, methadone, and morphine. These datasets included the years 2000-2004 and were used to compare the concentrations of these six drugs between people who died from a drug-related cause of death (of the drug of interest) and people who were pulled over for driving under the influence. Three drug pattern groups were created to divide each of the six drug-specific datasets in order to compare concentrations between individuals with the drug alone, the drug and ethanol, or a poly pharmacy of drugs (multiple drugs). An ANOVA model was used to determine if there was an interaction effect between the source dataset (ME or DUI) and the drug pattern groups. For diphenhydramine and cocaine, an interaction was statistically significant, but for the other drugs, it was not significant. The other four drug-specific datasets showed that the DUI and ME were statistically significantly different from each other, and all of those datasets except for methadone showed that there was a statistically significant difference between at least two drug pattern groups. Showing that all of these datasets showed differences between the ME and DUI datasets did not provide sufficient evidence to suggest the development of tolerances to each of the six drugs. One exception was with methadone because there were 14 individuals that had what is defined as a "clinical 'lethal' blood concentration". These individuals provide some evidence for the possibility of developing tolerances.The main outcomes of this study include suggesting changes to make to the ME datasets and the DUI datasets with regard to the way data is kept and collected. Several problems with the fields of these datasets arose before beginning the analysis and had to be corrected. Some of the changes suggested are currently being considered at the Virginia Office of the Chief Medical Examiner as they are beginning to restructure their database.
Books on the topic "Department of Chief Medical Examiner"
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Blanche, Tony. Death in paradise: An illustrated history of the Los Angeles County Department of Coroner. Los Angeles: General Pub. Group, 1998.
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Blanche, Tony. Death in paradise: An illustrated history of the Los Angeles County Department of Coroner. Los Angeles: General Pub. Group, 1998.
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Colin, Evans. Blood on the table: The greatest cases of New York City's Office of the Chief Medical Examiner. Waterville, Me: Thorndike Press, 2008.
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Francisco), California Grand Jury (San. San Francisco Police Department/Crime Laboratory (SFPD/CL) and San Francisco Medical Examiner/Toxicology Laboratory (SFME/TL). [San Francisco, Calif: Grand Jury, 1996.
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Center, DC Appleseed. Problems at the District of Columbia's Office of The Chief Medical Examiner: A recommendation for structural reform : DC Appleseed Center report. Washington, DC: DC Appleseed Center, 1998.
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Ribowsky, Shiya. Dead center: Behind the scenes at the world's largest medical examiner's office. New York: Regan, 2006.
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Great Britain. Department of Health. Chief Medical Officer. On the state of the public health: The annual report of the Chief Medical Officer of the Department of Health. London: HMSO, 1990.
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On the state of the public health: The annual report of the Chief Medical Officer of the Department of Health. London: HMSO, 1994.
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Great Britain. Department of Health. Chief Medical Officer. On the state of the public health: The annual report of the Chief Medical Officer of the Department of Health. London: HMSO, 1996.
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Great Britain. Department of Health. Chief Medical Officer. On the state of the public health: The annual report of the Chief Medical Officer of the Department of Health. London: HMSO, 1993.
Find full textBook chapters on the topic "Department of Chief Medical Examiner"
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Young, Thomas W. "Confessions of a Former Chief Medical Examiner." In The Sherlock Effect, 239–45. Boca Raton, FL : CRC Press, Taylor & Francis Group, [2018]: CRC Press, 2018. http://dx.doi.org/10.1201/9781351113830-21.
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Rainwater, Christopher W., Christian Crowder, Kristen M. Hartnett, Jeannette S. Fridie, Benjamin J. Figura, Jennifer Godbold, Scott C. Warnasch, and Bradley J. Adams. "Forensic Anthropology at the New York City Office of Chief Medical Examiner." In A Companion to Forensic Anthropology, 549–66. Chichester, UK: John Wiley & Sons, Ltd, 2012. http://dx.doi.org/10.1002/9781118255377.ch27.
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Walusinski, Olivier. "Chief Physician for the 1900 World’s Fair in Paris." In Georges Gilles de la Tourette, edited by Olivier Walusinski, 89–100. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190636036.003.0006.
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In 1896, Gilles de la Tourette was appointed head of the medical department for the 1900 World’s Fair in Paris. His nomination inevitably made him the object of intense envy and several venomous attacks by the press. He responded in the best way possible, by devoting himself to his duties. The fair’s medical department was perfectly organized and fulfilled all of its missions throughout the five years the event lasted, including its set-up and dismantling. The initial criticism was forgotten once Gilles de la Tourette set to work, leaving no room for further censure. This chapter examines his record and the malicious gossip aimed at discrediting him, while revealing a few well-kept secrets.
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Sojar, Sakina, and Lauren Allister. "What’s This Pounding in My Head?" In Pediatric Medical Emergencies, 123–30. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190946678.003.0013.
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Headaches are a common chief complaint within the pediatric emergency department. They can be a source of significant morbidity in the pediatric population causing severe pain, cognitive dysfunction, and missed school days. It is critical that the physician delineates between life-threatening versus non-life-threatening etiologies of headache and obtain imaging of the head when appropriate. Computed tomography and magnetic resonance imaging are the modalities of choice. Each imaging modality presents advantages and disadvantages. Common causes of headaches in the pediatric emergency department include migraine, tension headaches, and viral illness. Physicians must be aware of more serious etiologies (such as space occupying lesions) that may warrant further investigation.
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Miller, Craig A. "Tulane University: 1926–1935." In A Time for All Things, 34–91. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190073947.003.0002.
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Michael moves to New Orleans, has eye-opening experiences in the French Quarter, and his first-semester grades suffer. Influential professors shape his love of learning and research. He encounters Alton Ochsner, Chief of Tulane Department of Surgery and a highly influential future mentor. He has dramatic and defining clinical experiences at New Orleans’ Mercy and Charity Hospitals. While still a medical student, Michael invents a new transfusion syringe. The legendary surgeon and polymath Rudolph Matas befriends the eager young Michael, becoming another revered role model. DeBakey graduates from medical school at the top of his class and decides to become a surgeon, training under Ochsner.
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Croskerry, Pat. "Missed It." In The Cognitive Autopsy, edited by Pat Croskerry, 271–76. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190088743.003.0042.
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In this case, a middle-aged male presents in the early hours of the morning to the emergency department (ED) of a teaching hospital. His chief complaint is shortness of breath. His history is significant for chronic obstructive pulmonary disease (COPD), and he is diagnosed as having exacerbation of COPD. The ED physician calls a medical intern to do the admission, and the patient is taken to the floor. The patient does not settle, and the intern is called back to the floor twice. The second time the intern is called back, the patient deteriorates further and has a cardiac arrest from which he cannot be resuscitated. His true diagnosis is revealed at an autopsy later that day.
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Watkin, Sara, and Andrew Vincent. "Specialty-Specific Interviews." In The Consultant Interview. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199594801.003.0014.
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This chapter is designed to provide a brief insight into the differences between specialties and how they approach the interview process. It should be read in conjunction with Chapters 4 and 6. The specialties covered are: • Anaesthesia • Emergency medicine • Medicine • Psychiatry • Obstetrics and gynaecology • Paediatrics and neonatal specialities • Pathology and laboratory-based specialities • Radiology • Surgery Each of these sections has been written by a guest author from within that specialty. Across the board, they are all experienced, senior clinicians with many years’ experience in interviewing for consultants. However, it is also important to remember that they are individuals and each individual has their own unique way of thinking too. We have done comparatively little editing and given relatively free rein to those individuals in deciding what’s important. Each was provided with the broad section titles for some consistency. The content is very much their own and we have left it largely untouched so that you may get a feeling for style, psychology and focus, accepting that they are also unique too. As a consequence, although the section structure is consistent, you will find a considerable variation in what authors have chosen to focus on. In each specialty, we have provided a perspective on the likely psychology of the individuals you may come across. This is written by us, not the guest authors, who we can’t expect to have sufficient understanding of psychological difference. However, what we have written must never be taken as gospel. There is no substitute for being a good detective and finding out exactly who is on your panel and exactly how they are wired as individuals. Dr Helga Becker, Consultant Anaesthetist, Dudley Group of Hospitals NHS Foundation Trust. In terms of number of consultants, anaesthetics is often the single largest department in a Trust and so the interview panel will not be particularly representative of the department as a whole. Besides the usual suspects like Chief Executive and Medical Director, the panel will probably have the Clinical Director and maybe another consultant from the department.
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Rodger, James A. "Using Continuous Voice Activation Applications in Telemedicine to Transform Mobile Commerce." In Advances in Mobile Commerce Technologies, 258–97. IGI Global, 2003. http://dx.doi.org/10.4018/978-1-59140-052-3.ch012.
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This chapter is designed to relate the rationale used by the Department of Defense (DoD), for the military to adapt the principles of Mobile and Voice Commerce to meet increasing global crises and to find ways to more effectively manage manpower and time. A mobile Telemedicine package has been developed by the Department of Defense to collect and transmit near-real-time, far-forward medical data and to assess how this Web-based capability enhances management of the battlespace. Telemedicine has been successful in resolving uncertain organizational and technological military deficiencies and in improving medical communications and information management. The deployable, mobile teams are the centerpieces of this telemedicine package. These teams have the capability of inserting essential networking and communications capabilities into austere theaters and establishing an immediate means for enhancing health protection, collaborative planning, situational awareness, and strategic decision making through Web-based internet applications. In order to supplement this mobile commerce aspect of telemedicine, U.S. Navy ships have been utilized to integrate voice commerce interactive technologies to improve medical readiness and mobility. An experimental group was tasked to investigate reporting methods in health and environmental surveillance inspections to develop criteria for designing a lightweight, wearable computing device with voice interactive capability. This chapter is also designed to relate the rationale used by the Department of Defense and the Test and Evaluation (T&E) Integrated Product Team, in order to determine the military utility of the Joint Medical Operations—Telemedicine Advanced Concept Technology Demonstration (JMO-T ACTD) and continuous voice activation applications. Voice interactive computing devices are used to enhance problem solving, mobility and effectiveness in the battlespace. It improves efficiency through automated user prompts, enhanced data analysis, presentation, and dissemination tools in support of preventive medicine. The device is capable of storing, processing, and forwarding data to a server. The prototype devices have enabled quick, efficient, and accurate environmental surveillance. In addition to reducing the time needed to complete inspections, the device supported local reporting requirements and enhanced command-level intelligence. This chapter further focuses on developing a holistic model of implementing a strategy for mobile telemedicine. The model synthesizes current thinking on transformation into a holistic model and also explains the integrative influence of vision on the other four model components: environment, people, methodology, and IT perspective. The model was tested by Testing and Evaluating (T&E) the JMO-T ACTD. JMO-T ACTD has developed a very successful training program and is very aware of the importance of planned change. Top military officials, such as the Commander in Chief (CINC), are actively involved in change and are committed to people development through learning. The model served an applied purpose by allowing insights into how well the military organization fit current theory. The model also fit a theoretical purpose by organizing a holistic, comprehensive framework. Accordingly, we have organized and synthesized the literature into five interrelated components that act as a fundamental guide for research. The model also helped to identify a theoretical link and apply it to the internal operations of the military and its adaptation of mobile e-commerce principles to more effectively deliver telemedicine benefits to military personnel.
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Ashton, John. "Public health at its peak— the interwar years." In Practising Public Health, 20–32. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198743170.003.0002.
Full textAbstract:
This chapter picks up the evolution of public health in the United Kingdom in the period immediately following the First World War. The scene for initial optimism and ambition was set by the goals for reconstruction after the Great War which drove the move for ‘Homes Fit for Heroes’. The demand for resources distracted from the progress that was being made in bringing public health and health care together. Progress was made in organizational development, the appointment of the first Chief Medical Officer in the Department of Health, and the construction of pioneering health centres. The stock market crash and the recession that followed halted progress until the threats of fascism galvanized action in the public sector. The chapter also covers the evolution of public health from the sanitary movement of the 1840s, through the focus on hygiene at the end of the nineteenth century, to the therapeutic era, which began in the 1930s. The origins of the New Public Health, with the central role of the World Health Organization and the convergent thinking from North America and Europe, is described. The tension between hospital-dominated medicine and the preventive orientation of public health is explored. The emergence of a consensus for transformational change to health systems rooted in public health is chronicled. At the heart is a need to reconcile primary care and public health in the face of new challenges. The shift to multidisciplinary working is underlined.
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Henrichsen, Colleen. "Government Agencies." In A Field Guide for Science Writers. Oxford University Press, 2005. http://dx.doi.org/10.1093/oso/9780195174991.003.0048.
Full textAbstract:
A medical resident was on duty at New York Hospital one night in 1979 when a 27-year-old security guard was admitted with a rare form of pneumonia. As inexperienced as the resident was, he knew that this very rare condition was usually diagnosed only in people with a history of cancer, organ transplantation, or other conditions involving immune system suppression. This otherwise healthy young man had none of those. Weeks later, when the resident presented this case at inner-city rounds, a number of hands shot up. These clinicians had seen similar cases. The resident's report of this New York City outbreak was one of three that formed the basis for the first published report of the disease we would come to know as AIDS. Three years later, this physician, Dr. Henry Masur, arrived at the National Institutes of Health where he joined established NIH researchers already anxiously trying to understand this deadly new condition. At key communications offices on the NIH campus, phones were ringing incessantly. Reporters all around the world wanted to know what NIH was doing about it. As public communicators, we were learning about the disease along with the researchers. Why did it seem to disproportionately affect gay men? Why were people with the disease dying from ordinary infections? We were learning the answers to these questions as they unfolded, translating what we learned into plain English, and getting the information out to the public. A prominent AIDS researcher came into the office of one of my colleagues, sat next to her, and made a simple drawing of how immune cells appeared to be affected by the new virus, explaining it to her at the same time scientists themselves were just beginning to understand it. Dr. Masur is now chief of the Critical Care Medicine Department of the NIH Clinical Center. I covered his account of his first meeting with an AIDS patient for an NIH employee newsletter when he delivered the NIH Astute Clinician Lecture in 2002, which honors scientists who observe and investigate unusual clinical occurrences.