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7
53

America's Infant Mortality Crisis

As healthcare spending continues to grow, Fault Lines examines why so many babies are dying in the US.  
YouTube
over 7 years ago
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4
14

Incidence and Outcomes in Acute Kidney Injury: A Comprehensive Population-Based Study

Epidemiological studies of acute kidney injury (AKI) and acute-on-chronic renal failure (ACRF) are surprisingly sparse and confounded by differences in definition. Reported incidences vary, with few studies being population-based. Given this and our aging population, the incidence of AKI may be much higher than currently thought. We tested the hypothesis that the incidence is higher by including all patients with AKI (in a geographical population base of 523,390) regardless of whether they required renal replacement therapy irrespective of the hospital setting in which they were treated. We also tested the hypothesis that the Risk, Injury, Failure, Loss, and End-Stage Kidney (RIFLE) classification predicts outcomes. We identified all patients with serum creatinine concentrations ≥150 μmol/L (male) or ≥130μmol/L (female) over a 6-mo period in 2003. Clinical outcomes were obtained from each patient's case records. The incidences of AKI and ACRF were 1811 and 336 per million population, respectively. Median age was 76 yr for AKI and 80.5 yr for ACRF. Sepsis was a precipitating factor in 47% of patients. The RIFLE classification was useful for predicting full recovery of renal function (P < 0.001), renal replacement therapy requirement (P < 0.001), length of hospital stay [excluding those who died during admission (P < 0.001)], and in-hospital mortality (P = 0.035). RIFLE did not predict mortality at 90 d or 6 mo. Thus the incidence of AKI is much higher than previously thought, with implications for service planning and providing information to colleagues about methods to prevent deterioration of renal function. The RIFLE classification is useful for identifying patients at greatest risk of adverse short-term outcomes.  
jasn.asnjournals.org
about 6 years ago
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3
54

Inactivity, disability, and death are all interlinked

Physical activity has long been recognised as an important determinant of health and longevity, and many countries have explicit physical activity guidelines for promoting health.1 2 The corollary of this is that people who do not meet the guidelines, a substantial proportion of the population,3 are at risk of worse health. However, relatively little attention has been given to the question of how much activity is needed to make a difference. Although this is not explicitly their primary purpose, two new papers shed light on this question. Dunlop and colleagues (doi:10.1136/bmj.g2472) followed a cohort of people who had mild to moderate osteoarthritis or were at risk of osteoarthritis to look at the development of disability over two years.4 Cooper and colleagues (doi:10.1136/bmj.g2219) estimated the relation between physical capability in midlife—as indicated by grip strength, chair rise speed, and standing balance—and later mortality.5 Both showed that the relation between inactivity and risk of disability or death is not linear: people …  
bmj.com
over 7 years ago
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3
19

IP podcast - Economic Disparity And Childhood Mortality Due To Injury In Europe

Stream IP podcast - Economic Disparity And Childhood Mortality Due To Injury In Europe by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 6 years ago
Foo20151013 2023 7owyf5?1444773963
3
158

Benchmarking Outpatient Referral Rates

Introduction GPs for a little while have been asked to compare each other’s outpatient referrals rates. The idea is that this peer to peer open review will help us understand each others referral patterns. For some reason and due to a natural competitive nature of human behaviour, I think we have these peer to peer figures put to us to try to get us to refer less into hospital outpatients. It’s always hard to benchmark GP surgeries but outpatient referral benchmarking is particularly poor for several reasons It's Very Difficult to Normalise Surgeries Surgeries have different mortalities morbidities ages and other confounding factors that it becomes very hard to create an algorithm to create a weighting factor to properly compare one surgery against another. There Are Several Reasons For The Referral I’ll go into more detail on this point later but there are several reasons why doctors refer patients into hospital which can range from: doctors knowing a lot about the condition and picking up subtle symptoms and signs lesser experienced doctors would have ignored; all the way to not knowing about the condition and needing some advice from an expert in the condition. We Need To Look At The Bigger Picture The biggest killer to our budget is non-elective admissions and it’s the one area where patient, commissioner and doctor converge. Patients want to keep out of hospital, it’s cheaper for the NHS and Doctors don’t like the lack of continuity when patients go in. For me I see every admission to hospital as a fail. Of course it’s more complex than this and it might be totally appropriate but if we work on this concept backwards, it will help us more. Likewise if we try to reduce outpatient referrals because we are pressurised to, they may end up in hospitalisation and cost the NHS £10,000s rather than £100s as an outpatient. We need to look at the bigger picture and refer especially if we believe that referrals will lead to less hospitalisation of patients further down the line. To put things into perspective 2 symptoms patients present which I take very seriously are palpitations in the elderly and breathlessness. Both symptoms are very real and normally lead to undiagnosed conditions which if we don’t tackle and diagnose early enough will cause patients to deteriorate and end up in hospital. Education, Education, Education When I first went into commissioning as a lead in 2006 I had this idea of getting to the bottom of why GPs refer patients to outpatients. The idea being if we knew why, we would know how to best tackle specialities. I asked my GPs to record which speciality to refer to and why they referred over a 7 month period. The reason for admission was complex but we divided them up into these categories: 2nd care input required for management of the condition. We know about the condition but have drawn the line with what we can do in primary care. An example of this is when we’ve done a 24 hour tape and found a patient has 2sec pauses and needs a pace maker. 2nd care input required for diagnosis. We think this patient has these symptoms which are related to this condition but don’t really know about the diagnosis and need help with this. An example of this is when a patient presents with diarrhoea to a gastroenterologist There could be several reasons for this and we need help from the gastroenterologist to confirm the diagnosis via a colonscopy and ogd etc. Management Advice. We know what the patient has but need help with managing the condition. For example uncontrolled heart failure or recurrent sinusitis. Consultant to Consultant Referral. As advised between consultants. Patient Choice. Sometimes the patient just wants to see the hospital doctor. The results are enclosed here in Excel and displayed below. Please click on the graph thumbnail below. Reasons For Referrals Firstly a few disclaimers and thoughts. These figures were before any GPSI ENT, Dermatology or Musculosketal services which probably would have made an impact on the figures. There are a few anomalies which may need further thought eg I’m surprised Rheumatology for 2nd input for diagnosis is so low, as frequently I have patients with high ESRs and CRPs which I need advise on diagnoses. Also audiology medicine doesn’t quite look right. The cardiology referral is probably high for management advise due to help on ECG interpretation although this is an assumption. This is just a 7 month period from a subset of 8-9 GPs. Although we were careful to explain each category and it’s meaning, more work might need to be done to clarify the findings further. In my opinion the one area where GPs need to get grips with is management advice as it’s an admission that I know what the patient has and need help on how to treat them. This graph is listed in order of management advice for this reason. So what do you do to respond to this? The most logical step is to education GPs on the left hand side of this graph and invest in your work force but more and more I see intermediary GPSI services which are the provider arm of a commissioning group led to help intercept referrals to hospital. In favour of the data most of the left hand side of the graph have been converted into a GPSI service at one point. In my area what has happened is that referrals rates have actually gone up into these services with no decline in the outgoing speciality as GPs become dis-empowered and just off load any symptoms which patients have which they would have probably had a higher threshold to refer on if these GPSI services were not available. Having said that GPSI services can have a role in the pathway and I’m not averse to their implementation, we just have to find a better way to use their services. 3 Step Plan As I’m not one to just give problems here are my 3 suggestions to help referrals. To have a more responsive Layered Outpatient Service. Setting up an 18 week target for all outpatients is strange, as symptoms and specialities need to be prioritised. For example I don’t mind waiting 20 weeks for a ENT referral on a condition which is bothering me but not life threatening but need to only have a 3 week turn over if I’m breathless with a sudden reduction in my exercise tolerance. This adds an extra layer of complexity but always in the back of my mind it’s about getting them seen sooner to prevent hospitalisation. Education, education, education It’s ironic that the first budget to be slashed in my area was education. We need to education our GPs to empower them to bring the management advice category down as this is the category which will make the biggest impact to improving health care. In essence we need to focus on working on the left hand side of this graph first. Diagnose Earlier and Refer Appropriately The worst case scenario is when GPs refer patients to the wrong speciality and it can happen frequently as symptoms blur between conditions. This leads to delayed diagnosis, delayed management and you guessed it, increased hospitalisation. The obvious example is whether patients with breathlessness is caused by heart or lung or is psychogenic. As GPs we need to work up patients appropriately and make a best choice based on the evidence in front of us. Peer to peer GP delayed referral letter analysis groups have a place in this process. Conclusion At the end of the day it's about appropriate referrals always, not just a reduction. Indeed for us to get a grip on the NHS Budgets as future Clinical Commissioners, I would expect outpatient referrals to go up at the expense of non-elective, as then you are looking at patients being seen and diagnosed earlier and kept out of hospital.  
Raza Toosy
over 8 years ago
2
2
79

Focus On: Meningitis - Beyond Fever, Stiff Neck, and Altered Mental Status

Acute bacterial meningitis is a significant source of patient morbidity and mortality even when appropriate antibiotic therapy is initiated.  
American College Of Emergency Medicine
about 11 years ago
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2
41

Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study

Objective To evaluate the associations of dietary fiber after myocardial infarction (MI) and changes in dietary fiber intake from before to after MI with all cause and cardiovascular mortality.  
bmj.com
over 7 years ago
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2
38

Preterm birth and the role of neuroprotection

Preterm birth remains a common complication of pregnancy and causes substantial neonatal morbidity and mortality. As improvements in the care of preterm neonates have outpaced efforts to prevent preterm birth, the numbers of survivors with neurologic sequelae that affect quality of life have increased. The main strategies to reduce the impact of neurologic complications of prematurity include prevention of preterm birth and protection of the developing fetal brain through antenatal administration of drugs. These strategies rely on a basic understanding of the intertwined pathophysiology of spontaneous preterm labor and perinatal brain injury, which will be reviewed here. The review will outline current methods for the prevention of prematurity and neuroprotection. The use of magnesium sulfate as a neuroprotective compound will be discussed, including concerns over its association with increased pediatric mortality and abnormalities in bone density.  
bmj.com
almost 7 years ago
Preview
2
8

Opium soaked tampons, voodoo elixirs and leeches: welcome to New Orleans' Pharmacy Museum

Located in the townhouse of the US’s first licensed pharmacist, this lively, macabre, cringe-inducing museum provides a refreshing re-contextualization of its many artifacts and an unflinching encounter with our mortality  
the Guardian
almost 7 years ago
Foo20151013 2023 8mqjwi?1444774048
2
3896

An amazing incident

It's been a while since I've added any thoughts to this blog. In that time I have finished my Obs/Gynae placement, I have spent a week on labour ward, and done my first week of my 4th year surgical placement. All the while cramming in revision between various activities and general staying alive measures. This, I feel, is how most people who are sitting their final written exams are spending their time, so I don't feel so alone. I just want to bring to the attention one amazing incident that happened on my labour ward week. I was on a night shift, there wasn't a lot going on. Absolutely everyone was knackered, the registrar who'd been on nights for the past week was just chatting to me. I have never seen someone look so tired. The emergency alarm went off and a lady had a cord prolapse, which is an obstetric emergency with a high foetal mortality rate. Now I think it's amazing that the doctor went from nearly falling asleep to switched on 'surgical-mode' in an instant, successfully performed the C-section, delivering the baby in about a minute, then went back to being absolutely knackered and let the SHO close up the wound. It just really impressed me and I felt it was something worth sharing. Actually I was incredibly surprised that I enjoyed Obs/Gynae. Women's health was a placement I was dreading, it was my last major knowledge gap and I didn't have a clue what it was going to be like. If my tutor for the block does read this, thank you for all your help and getting me involved in everything. I would encourage other students who are going into it and feeling any level of apprehension to just throw yourselves into it and give 110% effort. It is a great placement for practicing transferable skills (this is important to remember, especially if you don't have any desire to go into it you CAN transfer and practice skills from elsewhere!) and getting heavily involved in patient care. Also I'd like to point out the Mother and Baby were fine :)  
Conrad Hayes
over 8 years ago
Foo20151013 2023 xyj9qx?1444774087
2
661

The NEW Birmingham Students Medical Leadership Society

Who are we? This society has been formed by a core group of clinical year medical students at the University of Birmingham. We are hoping that lots more healthcare students at UoB will join us soon. This society is open to any student who has a keen interest in healthcare management – Nurse, physio, BMedSc, Medical student, Business student, dentist and pharmacist are all welcome. Why do we exist? Healthcare has become more complex. To ensure that patient’s receive the most effective treatments then healthcare services need to be organised effectively. This might be your role one day and you won’t receive any formal training in management theory or on team working and leadership skills from the University – knowledge that is essential to providing the best care for our patients. Studies have shown that clinicians who have received management training and who take an active role in managing the departments they belong to have achieved significantly decreased complication and mortality rates. What do we plan to do? 1) Raise awareness amongst healthcare students about the opportunities to be involved in healthcare management in their future careers. 2) The society hopes to act as an intermediary between healthcare students keen to make contacts with likeminded individuals in other course and years. We intend to have regular social events that allow everyone to practice their essential networking skills while at discussions over coffee, nights out, games of golf or away day visits to conferences and organisational visits. 3) The society will be holding lectures given by eminent professionals from all areas of healthcare management – The NHS, DoH, Armed forces, private organisations, think tanks, consultancy firms and leading researchers. 4) The society aims to help students foster essential leadership and team working skills that will be required in their future professional roles. These skills will be developed informally and during seminars and workshops. These skills will then be put to the test in high stress situations like Paintballing, laser tag and outdoor activities. 5) The final main aim of this society is to help students make contacts with clinicians and researchers who are working on improving healthcare systems and who need healthcare students to help with research. We hope to develop a network of contacts who are willing to provide research and audit opportunities to keen students. Are you interested in joining the Birmingham Students Medical Leadership Society? Then please email the committee at: med.leadership.soc.uob@gmail.com Or join us on Facebook: https://www.facebook.com/groups/676838225676202/ Or come find us at the MedSoc Freshers fair in September. The Student medical leadership society (SMiLeS) useful resources!!! Why is it important? student BMJ 2012;345:e5319 http://www.leadingsystemsnetwork.com/pdf/Management_Matters.pdf http://www.bmj.com/rapid-response/2011/11/02/improving-performance-nhs http://www.bmj.com/content/345/bmj.e5015 http://www.ncbi.nlm.nih.gov/pubmed/?term=healthcare+reform Undergrad oppurtunities http://www.diagnosisltd.co.uk/ http://www.ihi.org/offerings/ihiopenschool/Pages/default.aspx http://www3.imperial.ac.uk/business-school/programmes/msc-health-management?gclid=CPTQy6bCwLgCFS3HtAodZ1sAtQ http://medicalleadership.net/committee/ http://www.lead-in.co.uk/ http://www.ihi.org/offerings/IHIOpenSchool/Chapters/Pages/SQLA.aspx Foundation year opportunities http://www.stfs.org.uk/faculty/leadership Future career opportunities http://www.leadership.londondeanery.ac.uk/home/fellowships%20in%20clinical%20education http://www.nuffieldtrust.org.uk/get-involved/harkness-fellowship Higher Education http://www.surrey.ac.uk/postgraduate/courses/business/healthcaremanagement/ http://www.open.ac.uk/health-and-social-care/main/study-us/leadership http://www.manchester.ac.uk/postgraduate/taughtdegrees/courses/atoz/course/?code=05855 http://www.brunel.ac.uk/bbs/mba/mba-specialisations/healthcare-management http://www.birmingham.ac.uk/students/courses/postgraduate/taught/social-policy/health-care-policy-management.aspx http://www.birmingham.ac.uk/schools/social-policy/departments/health-services-management-centre/index.aspx Free Learning/ Relevant organisations http://www.qficonsulting.com/healthcare/qfi-healthcare http://www.tocthinkers.com/ http://www.tocthinkers.com/2012/05/qa-performance-improvement-for-healthcare-leading-change-with-lean-six-sigma-and-constraints-managem.html http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/theory_of_constraints.html http://www.dbrmfg.co.nz https://www.google.co.uk/search?q=theory+of+constraints&rlz=1C1CHMC_enGB501GB502&oq=Theory+of+con&aqs=chrome.0.0j69i57j5j69i65j0j69i62.4977j0&sourceid=chrome&ie=UTF-8 http://en.wikipedia.org/wiki/Theory_of_constraints http://www.york.ac.uk/che/ http://www.ihm.org.uk/ Relevant Journals http://www.bmj.com/highwire/filestream/342359/field_highwire_article_pdf/0/bmj.c5072.full.pdf www.civitas.org.uk/doctors/index.php http://www.bmj.com/highwire/filestream/342359/field_highwire_article_pdf/0/bmj.c5072.full.pdf http://www.hsj.co.uk/# http://www.bjhcm.co.uk/ book list http://www.amazon.co.uk/Performance-Improvement-Healthcare-Constraints-ebook/dp/B005RWFOSE/ref=sr_1_1?ie=UTF8&qid=1374945477&sr=8-1&keywords=Performance+Improvement+for+Healthcare http://www.amazon.co.uk/s/ref=nb_sb_ss_i_0_6?url=search-alias%3Ddigital-text&field-keywords=goldratt&sprefix=Goldra%2Cdigital-text%2C142&rh=i%3Adigital-text%2Ck%3Agoldratt Final Summary Did you know that you may not just work for the NHS, but also help to run it? The new Medical Leadership Society aims to foster leadership skills in healthcare students through talks from NHS leaders, the DoH and even the Armed Forces. We provide a way for you to learn about being a leader and influencing policies in the NHS, and our talks and events will serve as an excellent platform for you to start making influential contacts within areas that interest you. You’ll also practice those leadership skills in an array of activities, including paintballing and laser tag!  
jacob matthews
about 8 years ago
Foo20151013 2023 1juzlhe?1444774136
2
330

Dr Mark Newbold “Why Should Doctors Get Involved in Management – Understanding the Problems” - Birmingham Medical Leadership Society Lecture 3

The Birmingham Student’s Medical Leadership Society (MLS) held it’s third and final lecture of 2013 on Thursday December 5th. The final lecture was given by Dr Mark Newbold CEO of the Heart of England NHS Foundation Trust and was a particularly enlightening end to our autumn lecture series on why healthcare professionals should become involved in management and leadership. In contrast to the previous talk by Mr Tim Smart this lecture did not focus on why doctors would be suitable for management roles but rather on why clinical leadership is absolutely necessary to tackle the fundamental problems in our hospitals today. Once again, the Birmingham MLS heartily thanks Dr Newbold for giving up his valuable time to speak to us and we must also thank Michelle and Angie for video recording this event as well. Fingers crossed, the recordings of both of our last events should be available fairly shortly. The lecture began with a brief career history of why and how Dr Newbold became involved in hospital management, from front line doctor, to department lead and on to chief exec of a major NHS foundation trust. The second part of the lecture was a brief history of the recent NHS beginning with the Labour years. Between 1997 and 2010 NHS funding increased enormously, which was a good thing. Targets increased proportionally with the funding, not necessarily a good thing. Expectations to meet the targets at all costs and punishments for failure also increased, not a good thing. Focus became diverted from providing the best possible care to ensuring that the hospital didn’t go bankrupt from failing to hit it’s targets. The “budget culture” was an unintended consequence of overzealous central target setting. This system did have some major successes, such as overall reduced waiting times and new specialist urgent cancer referral pathways. However, these successes did not necessarily transform into better patient care or higher patient satisfaction. This came to ahead as well all know with the Mid-Staffs Enquiry, the Francis report and the Keogh review. The recent NHS reforms have tried to change the NHS management culture away from target driven accounting and more towards affordable, yet excellent patient care – a “quality culture”. The NHS structural reforms have been well meaning but messy and complicated. The NHS culture change has begun, but trying to change something as huge as the NHS is like trying to steer an oil tanker, it takes time for the tiniest change in direction to be noticed. Add to this list of changes, an ever ageing population, an ever growing population, an increasingly chronically ill, co-morbid population and a relative freeze in budget and you can start to see why NHS managers are having such a tough time at the moment. How can NHS managers adopt this culture? Put their priorities in order. Quality care + Patient satisfaction > Waiting lists > Budgets Engage with the public in a more meaningful way. Have a social media presence so that you, your hospital and its staff are more than just a faceless organisation. Have a twitter account and write blogs about your challenges and successes. This will increase patient satisfaction with your hospital. Ask for and listen to patient reviews regularly. Make sure these reviews are public and this will help ensure that any changes made are recognised. Better articulate why you are changing a service, e.g. you are not shutting a local A/E to save money but to save lives! Specialist centres have been shown to have better patient outcomes than smaller, less specialised centres. The London stroke service reforms are an excellent example of this principle. Realise that a budget is a constraint, not an aim! Create a dialogue with doctors about which targets are important and why they are important. If doctors don’t agree with the targets then they will not try to improve the measures. For example, the A/E 4 hour waiting time target annoys a lot of healthcare professionals, who see it as a criticism of their work. However, this target is in fact not a measure of A/E efficiency but actually a measure of FLOW through the entire hospital. If the 4h target is missed then there is a problem within the hospital system as a whole and the doctors needed to be aware that their service is reaching capacity and that this may affect their practice. They should also consider why the 4h target was missed and what can they do to increase the patient flow through the hospital – are they needed in an understaffed department? The essence of this part of the lecture can be summarised by saying that “poor hospital performance has consequences for that hospital and its staff, these consequences affect clinical care and therefore, healthcare professionals need to care about the bigger picture otherwise it will affect frontline care”. The next part of the talk went on to outline some of the recent problems that Dr Newbold has been made aware of and how this affects his hospitals performance. 35% of patients who present to the A/E department have at least 1 chronic condition. 12% of patients are re-admitted within 30 days. Did they receive suboptimal care the first time? Patients who are re-admitted have a far higher mortality rate than other patients. Once, a patient has been in hospital for longer than 5 days their mortality rate begins to rise drastically. Being in a hospital is bad for your health and patients are often not discharged as soon as they should be. A hospital of 1500 people needs to discharge over 200 patients a day just to maintain its flow of patients. If this discharge rate decreases then the pressure on the system increases and beds are no longer available, which starts to decrease the services a hospital can provide, such as elective operations. Hospitals tend to be managed on 4 layers of alert. When the hospital is on top alert i.e. the most under pressure, mortality rates can be up to 8% higher than when the hospital is at its least pressured. By not discharging patients promptly, doctors are increasing the pressure on the system as a whole with awful unintended consequences for the patients. By admitting patients to the wards, who do not necessarily require in-patient care, doctors are also increasing the pressure on the system. Bed blocking has consequences for the patients, not just the budgets. The list above demonstrates how unintended consequences of frontline staff decisions affect patient outcomes. That is why it is critical that frontline staff are involved with helping to improve some of these problems. Does that patient really need to be admitted to an already full hospital? Does that patient really need to stay on the ward until Friday? Did that man with an exacerbation of asthma get the best acute treatment and has a plan been made for his long term management that will decrease the chance of him re-admitting? Healthcare staff can help by adjusting their practice to the situation and by helping to change the systems overall, so that the above consequences are less likely to occur. This part of the lecture was really quite sobering. It spelled out some hard facts about how such a complex system as a hospital operates. But more importantly it helped clarify just what needs to be done in the future to make hospital care the best it can be. Dr Newbold quoted the RCP report “Hospitals are not the problem, they have a problem” to highlight his believe that in the future the health service needs to change to be less focussed on acute crises and more focussed on exacerbation prevention. Hospitals should be a last resort, not a first choice. Hospitals themselves need to change how they deliver care. NHS staff need to explore ways of providing their services in an ambulatory fashion, so that patients don’t need to stay on the wards for any pre-longed period of time but come and go as quickly as possible. This will involve a major shake up in how hospital trusts fund care. They will need to increase their funding for the provision of more services at home. They need to get their employs out of the hospital and into the community. They need to work more closely with GP’s and with local social services. As the previous Chief Medical Officer said “Good Health is about team work”. Only when GP’s, community staff, hospital staff and social services work as a team will patient care really improve. At the present The University of Birmingham Students Medical Leadership Society is in contact with the FMLM and other similar groups at the Universities of Bristol, Barts and Oxford. We are looking to get in contact with every other society in the country. If you are a new or old MLS then please do get in touch, we would love to hear from you and are happy to help your societies in any way we can – we would also love to attend your events so please do send us an invite. Email us at med.leadership.soc.uob@gmail.com Follow us on Twitter @UoBMedLeaders Find us on Facebook @ https://www.facebook.com/groups/676838225676202/ Come along to our up coming events… Wednesday 22nd January 2014 LT3 Medical School, 6pm ‘Has the NHS lost the ability to care?’ – responding to the Mid Staffs inquiry’ By Prof Jon Glasby, Director of the Health Services Management Centre , UoB Thursday 20th February LT3 Medical School, 6pm ‘Reforming the West Midlands Major Trauma Care” By Sir Prof Keith Porter, Professor of Traumatology, UHB Saturday 8th March WF15 Medical School, 1pm “Applying the Theory of Constraints to Healthcare” By Mr A Dinham and J Nieboer ,QFI Consulting  
jacob matthews
almost 8 years ago
8
1
82

Pancreatitis - Surgical Indications and Procedures

<p>This is the third in the series on severe pancreatitis and necrotizing pancreatitis. &nbsp;This episode reviews the indications for surgery, morbidity and mortality of surgery, and what are the surgical options. &nbsp;</p>  
Jeffrey S. Guy, MD, FACS
about 11 years ago
7
1
41

Hemoglobin Based Blood Substitutes: Increased Morbidity and Mortality

In this week's <em>Journal of the American Medical Association</em> a meta-analysis was published that concluded that use of hemoglobin based blood substitutes result in an increased morbidity and mortality.&nbsp; Included in the same journal is an editorial critical of the method the research has been regulated by the US FDA.&nbsp;&nbsp;  
Jeffrey S. Guy, MD, FACS
about 11 years ago
13
1
66

Why is invasive aspergillosis such a difficult disease to diagnose and treat? by Marta Stanzani

Dr Stanzani explains that fungal cells are very similar to human cells, and that drugs which are toxic to fungals cells may have the same effect on human cells. Mortality in invasive aspergillosis depends largely on the timing of the intervention, timely diagnosis and the state of the patient’s defences – treatment is much more effective when people have an intact immune system.  
Aspergillus Website
about 11 years ago
Preview
1
28

NHS death rates 'should be ignored' - BBC News

A key measure of hospital death rates should be ignored, according to the expert who is leading the NHS review into them.  
BBC News
over 7 years ago
Preview
1
28

Eating Disorders

Anorexia Nervosa This is a psychological disorder, in which there is a relentless pursuit of thinness. Anorexia is significant as it has a very high mortality rate: 1/3 of patients make a complete recovery 1/3 make only partial recovery and have many relapses  
almostadoctor.com - free medical student revision notes
over 7 years ago
Www.bmj
1
21

Prevention and management of pressure ulcers in primary and secondary care: summary of NICE guidance

Pressure ulcers are serious and distressing, and they can affect people of any age. Not only do they increase mortality, result in extended hospital stays, and consume substantial healthcare resources, they are often an example of avoidable harm. Reported prevalence rates range from 4.7% to 32.1% in hospital populations and as much as 22% in nursing home populations.1 Prevention of this devastating condition must be a priority for the NHS. Stage 1 pressure ulcers (see box for definition of stages) can be reversible if identified promptly, and most stage 2 and 3 ulcers can be healed with appropriate care, but all require a multidisciplinary approach for effective management. It is hoped that this guideline will help reduce pressure ulcers nationally and improve care when pressure ulcers do occur.  
www.bmj.com
over 7 years ago