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Handling(Psychology)

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29621
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Window to the Brain

Anatomy and pathology of the nervous system is understood by directly visualizing it. This is best accomplished by handling the brain (or model of the brain as the case may be) and dissecting or taking it apart for direct examination. The purpose (for the clinician) of understanding neuroanatomy and neurophysiology is to be able to use that knowledge to solve clinical problems. The first step in solving a clinical problem is anatomical localization. So, if one cannot directly inspect the patient's brain, how is this localization accomplished? The "window" to the patient's brain is the neurological examination. The neuro exam is a series of tests and observations that reflects the function of various parts of the brain. If the exam is approached in a systematic and logical fashion that is organized in terms of anatomical levels and systems then the clinician is lead to the anatomical location of the patient's problem.  
Neurologic Exam
about 8 years ago
30091
3
115

Hyperkalaemia - Part One (Physiology)

Video tutorial on hyperkalaemia. This is a first part tutorial and covers the physiology (including cellular handling and renal excretion) followed by pathophysiology.  
Podmedics
about 7 years ago
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1
6

Adults 'unaware of NHS data plans' - BBC News

Fewer than a third of adults in England recall getting an a leaflet about changes to the handling of medical records, a poll for the BBC suggests.  
BBC News
almost 5 years ago
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1
16

3. Instrument Handling [Basic Surgery Skills]

Watch the complete series of videos: http://doctorprodigious.wordpress.com/2014/05/02/basic-surgery-skills-royal-college-of-surgeons/  
YouTube
over 4 years ago
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1
13

Mers virus: Saudis warned to wear masks near camels - BBC News

The authorities in Saudi Arabia advise wearing masks and gloves when handling camels to avoid spreading the Mers virus, which has killed at least 133 in the kingdom.  
BBC News
over 4 years ago
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1
9

3. Instrument Handling [Basic Surgery Skills]

Watch the complete series of videos: http://doctorprodigious.wordpress.com/2014/05/02/basic-surgery-skills-royal-college-of-surgeons/  
YouTube
about 4 years ago
Foo20151013 2023 1f9109k?1444774063
2
1928

Criticizing the NHS - Can students do this productively?

In this month’s SBMJ (May 2013) a GP called Dr Michael Ingram has written a very good article highlighting some of the problems with the modern NHS’s administrative systems, especially relating to the huge amount of GP time wasted on following up after administrative errors and failings. I personally think that it is important for people working within the NHS to write articles like this because without them then many of us would be unaware of these problems or would feel less confident in voicing our own similar thoughts. The NHS is a fantastic idea and does provide an excellent service compared to many other health care systems around the world, but there is always room for improvement – especially on the administrative side! The issues raised by Dr Ingram were: Histology specimens being analysed but reports not being sent to the GP on time or with the correct information. Histology reports not being discussed with patient’s directly when they try and contact the hospital to find out the results and instead being referred to their GP, who experiences the problem stated above. GP’s are being left to deal with patient’s problems that have nothing to do with the GP and their job and have everything to do with an inefficient NHS bureaucracy. These problems and complaints often taking up to a third of a GP’s working day and thereby reducing the time they can spend actually treating patients. Having to arrange new outpatient appointments for patients when their appointment letters went missing or when appointments were never made etc. Even getting outpatient appointments in the first place and how these are often delayed well after the recommended 6 week wait. Patients who attend outpatient appointments often have to consult their GP to get a prescription that the hospital consultant has recommended, so that the GP bares the cost and not the hospital. My only issue with this article is that Dr Ingram highlights a number of problems with the NHS systems but then does not offer a single solution/idea on how these systems could be improved. When medical students are taught to write articles for publication it is drummed into us that we should always finish the discussion section with a conclusion and recommendations for further work/ implications for practice. I was just thinking that if doctors, medical students, nurses and NHS staff want to complain about the NHS’s failings then at least suggest some ways of improving these problems at the same time. This then turns what is essentially a complaint/rant into helpful, potentially productive criticism. If you (the staff) have noticed that these problems exist then you have also probably given some thought to why the problem exists, so why not just say/write how you think the issue could be resolved? If your grievances and solutions are documented and available then someone in the NHS administration might take your idea up and actually put it into practice, potentially reducing the problem (a disgustingly idealist thought I know). A number of times I have been told during medical school lectures and at key note speeches at conferences that medical students are a valuable resource to the NHS administration because we visit different hospitals, we wander around the whole hospital, we get exposed to the good and bad practice and we do not have any particular loyalty to any one department and can therefore objective observations. So, I was thinking it might be interesting to ask as many medical students as possible for their thoughts on how to improve the systems within the NHS. So I implore any of you reading this blog: write your own blog about short comings that you have noticed, make a recommendation for how to improve it and then maybe leave a link in the comments below this blog. If we start taking more of an interest in the NHS around us and start documenting where improvements could be made then maybe we could together work to create a more efficient and effective NHS. So I briefly just sat down and had a think earlier today about a few potential solutions for the problems highlighted in Dr Ingram’s article. A community pathology team that handles all of the GP’s pathology specimens and referrals. A “patient pathway co-ordinator” could be employed as additional administrative staff by GP surgeries to chase up all of the appointments and missing information that is currently using up a lot of the GP’s time and thereby freeing them to see more patients. I am sure this role is already carried out by admin staff in GP practices but perhaps in an ad hoc way, rather than that being their entire job. Do the majority of GP practices get access to the hospitals computer systems? Surely, if GPs had access to the hospital systems this would mean a greater efficiency for booking outpatient appointments and for allowing GPs to follow up test results etc. In the few outpatient departments I have come across outpatient appointments are often made by the administration team and then sent by letter to the patients, with the patient not being given a choice of when is good for them. Would it not be more efficient for the administrative staff to send the patients a number of appointment options for the patient to select one appropriate for them? Eliyahu M. Goldratt was a business consultant who revolutionized manufacturing efficiency a few years ago. He wrote a number of books on his theories that are very interesting and easy to read because he tries to explain most of his points using a narrative – “The Goal” and “Critical Chain” being just tow. His business theories focussed on finding the bottle neck in an industrial process, because if that is the rate limiting step in the manufacturing process then it is the most essential part for improving efficiency of the whole process. Currently, most GPs refer patients to outpatient appointments at hospitals and this can often take weeks or months. The outpatient appointments are a bottle neck in the process of getting patients the care they require. Therefore, focussing attention on how outpatient appointments are co-ordinated and run would improve the efficiency in the “patient pathway” as a whole. a. Run more outpatient clinics. b. Pay consultants overtime to do more clinics, potentially in the evenings or at weekends. While a lot may not want to do this, a few may volunteer and help to reduce the back log on the waiting lists. c. Have more patients seen by nurse specialists so that more time is freed up for the consultants to see the more urgent or serious patients. d. An obvious, yet expensive solution, hire more consultants to help with the ever increasing workload. e. Change the outpatient system so that it becomes more of an assembly line system with one doctor and a team of nurses handling the “new patient” appointments and another team handling the “old patient” follow up appointments rather than having them all mixed together at the same time. I am sure that there are many criticisms of the points I have written above and I would be interested to hear them. I would also love to hear any other solutions for the problems mentioned above. Final thought for today … Why shouldn’t medical students make criticisms of inefficiencies and point them out to the relevant administrator? If anyone else is interested in how the NHS as a whole is run then there is a new organisation called the Faculty of Medical Leadership and Management that is keen to recruit interested student members (www.fmlm.ac.uk).  
jacob matthews
over 5 years ago
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Pharmacology Application in Athletic Training

Here's the information students need to know about how drugs work and how they can affect athletic performance. Through "real life" scenarios, students gain insights into the application of pharmacology in their clinical practice—from assisting an athlete who is taking a new medication to recognizing drug-related side effects when a negative reaction is occurring to handling instances of drug abuse. Beginning with an overview of pharmacokinetics and pharmacodynamics, the text presents prescription and over-the-counter medications in relation to the injuries or health conditions athletic trainers commonly encounter. Frequently abused substances such as amphetamines, herbals, and anabolic steroids are also addressed. Legal and ethical issues of drug use are presented, such as HIPAA–mandated privacy issues, drug testing, and which drugs are deemed as acceptable or banned according to NCAA and US Olympic standard.  
books.google.co.uk
over 3 years ago
Www.bmj
0
8

WHO pledges to tackle failings over handling of Ebola

The World Health Organization has issued a strongly worded criticism of itself over its handling of the outbreak of Ebola virus disease, pledging to take steps to ensure that such a failure did not happen again.  
feeds.bmj.com
over 3 years ago
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GP commissioners are not monitoring private contracts effectively, think tank says

A think tank has questioned whether the NHS in England can monitor the safety and effectiveness of thousands of contracts outsourced to the private sector. The Centre for Health and the Public Interest said that new information from clinical commissioning groups (CCGs) raised fresh doubt over the handling of some 15 000 contracts.  
feeds.bmj.com
over 3 years ago
Www.bmj
0
8

WHO pledges to tackle failings over handling of Ebola

The World Health Organization has issued a strongly worded criticism of itself over its handling of the outbreak of Ebola virus disease, pledging to take steps to ensure that such a failure did not happen again.  
feeds.bmj.com
over 3 years ago
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SGEM#87: Let Your Back Bone Slide (Paracetamol for Low-Back Pain)

Guest Skeptics: Dr. Pal Ager-Wick is from Norway. Consultant at Legevakten in Drammen, which is a GP run ED handling most things except major trauma. Keen interest in everything evidence based especially ultrasound. Pal is bringing Matt and Mike from the Ultrasound podcast to Norway.  
thesgem.com
over 3 years ago
5
3
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Going to work in a different country? Different culture? Different language? Avoid getting tripped up as I did!

I grew up in Belgium and went to medical school in Louvain, Belgium. I came to the USA for my internship and selected a small hospital in upstate New York. What an initial culture shock that was! The first problem was the language. I knew enough "school" English to get by, or so I thought. Talking on the phone was the hardest. Initially, the nurses in the hospital thought that I was the most conscientious intern they had ever worked with. When I was on duty and the nurses called me on the phone at night, I would always go to the ward, look over the chart, see the patient and then write a note and orders, rather than just handle things over the phone like all the other interns did when called for rather minor matters. Little did the nurses realize that the reason I would get up in the middle of the night and physically go to the ward was due to the fact that I had no idea what they were talking about. I did not understand a word of what the nurses were telling or asking me on the telephone, especially not when they were using even common American abbreviations, like PRN, QID, LMP etc. [PRN (Latin) means as needed; QID (Latin) means four times a day and LMP means last menstrual period]. That problem rapidly resolved as I began to understand more and more of the English medical terms. However, there is a major difference between understanding day-to-day common English and grasping all the idioms and sayings. A rather amusing anecdote will illustrate that. About two months into my internship, I was on call at night when one of the nurses telephoned me in the early evening. A patient (Mrs X) was having a bad headache and wanted something for it. I was proud that I had understood the problem over the phone and was even more proud that I managed to order something for her headache without having to walk over to the ward. An hour or so later, the same nurse called me for the same patient because she had been constipated and wanted something for it. Again I understood and again I was able to prescribe a laxative over the phone without having to go to see the patient. A while later the same nurse called to let me know that Mrs X was agitated and wanted something for sleep. I understood again and prescribed a sleeping pill. Close to the 11pm shift change the same nurse called me once more: "Dr. LeMaire, I am so sorry to keep bothering you about Mrs X, but she is really a pain in the neck…" Immediately some horrible thought occurred to me. Here is a patient who has a bad headache, is constipated and agitated and now has a pain in her neck. These could all be symptoms of meningitis and here I have been ordering medications over the phone for a potentially serious condition. I broke out in a cold sweat and I told the nurse "I am coming." I ran over to the ward where that patient was hospitalized, went to her room and after introducing myself said "Mrs. X, the nurse tells me that you have a pain in your neck." The rest is history. The patient lodged a complaint about the nurse and me, but we both got off with a minor reprimand and in fact somewhat of a chuckle by the administrator handling the complaint. Such tripping up by the idioms and sayings can of course happen in any language. Be aware! Dr. William LeMaire  
DR William LeMaire
over 3 years ago
Www.bmj
0
14

WHO should be able to impose sanctions on states that ban travel to countries with epidemics, panel says

The World Health Organization should have greater power to stop countries imposing trade and travel barriers on regions affected by outbreaks of infectious disease, the chair of a panel looking into WHO’s handling of the Ebola outbreak has said.  
feeds.bmj.com
over 3 years ago
Sinaiem dark
0
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what-lies-beneath

24 y/o male working at the local aquarium presents with right hand redness, pain, and swelling after handling an exotic fish. He is able to snap a picture of the fish before presenting to the ED. What’s your diagnosis?  
sinaiem.org
over 3 years ago
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WHO is unfit for health emergencies, says independent panel

The World Health Organization lacks the capacity and culture to deal with health emergencies, an independent report into WHO’s handling of the Ebola epidemic has found.1  
feeds.bmj.com
over 3 years ago
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WHO is unfit for health emergencies, says independent panel

The World Health Organization lacks the capacity and culture to deal with health emergencies, an independent report into WHO’s handling of the Ebola epidemic has found.1  
feeds.bmj.com
over 3 years ago
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Critical Care

Brunner et al. [1] showed a higher than previously described prevalence of renal tubular acidosis (RTA) in critically ill patients with hyperchloremic metabolic acidosis (HMA). They elegantly demonstrated that this condition often remains unrecognized owing to the simultaneous presence of metabolic alkalosis, mainly attributed to low plasma albumin levels, and was not associated with increased morbidity or mortality. HMA was thought to result from altered renal chloride handling as seen in RTA and was considered a nonharmful physiological response.  
ccforum.com
over 3 years ago
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0
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Dan Poulter: Junior doctors rightly upset over contract - BBC News

A former Conservative health minister has criticised the Government's handling of controversial reforms to junior doctors' contracts.  
bbc.co.uk
about 3 years ago
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Former Tory health minister attacks new junior doctor contract

A former Conservative health minister has delivered a scathing attack on the government’s handling of the new contract for UK junior doctors.  
feeds.bmj.com
about 3 years ago