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Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’

Stream Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’ by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 6 years ago
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Looking back at building the evidence base for safe and active bicycling

Stream Looking back at building the evidence base for safe and active bicycling by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 6 years ago
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Posts by caseoftheweek | MCEM Part A, MCEM Part B, MCEM Part C Emergency Medicine Courses

A normally fit and well 54year man presented to the emergency department with generalised swelling. He had fallen the previous day, and hit his back on a door handle. He had taken a dose of ibuprofen for the pain and noticed increasing swelling to his chest and face since.  
MCEM Part A, MCEM Part B, MCEM Part C Emergency Medicine Courses
over 6 years ago
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Duke Anatomy - Lab 22: Retropharyngeal space

In the last lab you examined many of the structures on the anterior surface of the neck, and looked briefly at the retropharyngeal space and its contents while moving them aside, but you have not yet dissected those structures in detail. Today you will explore the prevertebral area and the back of the pharynx (retropharyngeal space) in much more detail. In order to do this the head must be detached from the vertebral column to allow a posterior approach to the cervical viscera. This is a challenging and labor-intensive dissection.  
web.duke.edu
over 6 years ago
Foo20151013 2023 1n8q51t?1444774287
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Email Gone Astray

An email gone astray can provide fascinating insights for an unintended recipient. Written correspondence has undoubtedly fallen into the wrong hands since homo sapiens first put pigment on bark, but never before has it been so easy to have a personal message go awry. No longer is it a matter of surreptitiously steaming open sealed letters or snooping around in wastepaper baskets. Finding out another's personal business is now just a click away. Even more conveniently, candid opinions can sometimes make an unscheduled landing in your inbox, making for intriguing reading -- as I discovered. Some time ago, I'd sent out feelers regarding possible new GP jobs and had emailed a particular practice principal a couple of times, expressing interest. When it looked likely that I was going to pursue a different path, I sent a polite email explaining the situation and telling him I wouldn't be seeking an interview for a job at his practice at present. An email bounced back saying that my not wanting to work for him may be "a relief" as I "sounded a bit intense". It was sans salutation but, based on the rest of the content, was obviously intended for one of his work colleagues. It had no doubt been a simple error of his pressing 'reply' rather than 'forward'. I was chuffed: I've never been called "intense" before, at least, not to my knowledge. Perhaps there are several references to my intensity bouncing around cyberspace but this is the only one my inbox has ever captured. I've never considered myself an intense person. To me, the term conjured up the image of a passionate yet very serious type, often committed to worthy causes. Perhaps I had the definition wrong. I looked it up. The Oxford Dictionary gave me: "having or showing strong feelings or opinions; extremely earnest or serious". Unfortunately, I couldn't reconcile my almost pathologically Pollyanna-ish outlook, enthusiasm, irreverence and light-heartedness to this description -- nor my somewhat ambivalent approach to politics, religion, sport, the environment and other "serious" issues. At least the slip-up was minor. Several years ago, I unintentionally managed to proposition one of my young, shy GP registrars by way of a wayward text message. He had the same first name as my then-husband. Scrolling through my phone contacts late one night, alone in a hotel room at an interstate medical conference, I pressed one button too many. Hence this innocent fellow received not only declarations of love but a risqué suggestion to go with it. Not the usual information imparted from medical educator to registrar! It took me several days to realise my error, but despite my profuse apologies, the poor guy couldn't look me in the eye for the rest of the term. If I was "intense", I would conclude on a ponderous note -- with a moral message that would resonate with the intellectually elite. Alas, I'm a far less serious kind of girl and, as a result, the best I can up with is: Senders of emails and texts beware -- you are but one click away from being bitten on the bottom. (This blog post has been adapted from a column first published in Australian Doctor). Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work here.  
Dr Genevieve Yates
over 7 years ago
Foo20151013 2023 ybwd01?1444774304
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The NHS should care … for it's staff

The NHS is one of the largest employers in the world. It is one of the largest healthcare providers in the world and it is one of the most loved and needed institutions in this country. The downsides to the NHS is that it is constantly ‘in crisis’ and it is expected to provide better care and newer treatments with less money and not enough staff. Recently, this has caused a significant drop in staff morale and the beginnings of an exodus of trained staff out of the NHS. This needs to be addressed. If you read almost any management textbook, journal article or magazine, they will tell you that happy staff perform better. This ethos is easy to theorise but less easy to practice. Companies like Google and Apple have taken this to heart but so did some of the old Victorian companies like Cadbury’s and Roundtree. These companies aimed to make a profit but also to invest and look after their staff because of moral and economic principles… and it worked. I believe the NHS needs to embrace this old fashioned paternalistic concept, if it wishes to continue to be a world leader in excellent, affordable healthcare and professional training. If the NHS invests in its staff now, it will increase staff morale, encourage people to stay working in the NHS and ensure top quality patient care. The reforms Staff canteens open 24/7 (or near enough), that serve good quality, healthy and affordable food. If staff have to work unsociable shifts, it seems unfair not to provide them with the chance to eat a healthy meal at 2am rather than a Domino's. Staff canteens also allow the staff to unwind and socialise away from the wards and the public, they can be unofficial hubs of productivity where the 'real business' takes place away from the meetings. Staff rooms with free tea and coffee - it doesn't cost much and every appreciates a 'cuppa'. A** crèche** for the children of staff, on site or nearby. Reduces the stress of having to take children to carers and pick them up, allows greater flexibility for the staff. Free staff car parking (if they car share). Staff have to get to work and cars are the most practical way for most people, so why punish them by charging car parking? An onsite gym that is free/reduced price for staff and open 24/7 so that staff can pop in around their various shifts. The physio gym could just be expanded so patients and staff use the same facilities. Providing healthcare is stressful, takes long hours and is antisocial. All these factors make it easy to put on weight, especially with most hospitals only providing unhealthy meals, Costa and Gregs. So, an onsite gym would make it a lot more convenient for the staff to get the exercise they need to burn off all that stress and calories. Healthier, happier staff! A hospital/ centre social society like a student ‘MedSoc’ to organise staff socials and sports teams etc. This organisation could even organise special events for the staff like a summer ball or sports day. Anything fun that would bring the staff together and let them blow off steam. It could easily incorporate, elected officials from the professional bodies and elected representatives of the different employees and act as an unofficial staff voice. Regular staff forums that allow each group of employees to raise concerns or solutions to problems with the organisations management and senior staff. Staff rota’s should not just be imposed by management but should be organised in a flexible manner that allows staff input. The NHS management should encourage and provide extra learning opportunities for the staff. By investing in staff education they provide people with opportunities to develop them selves which will benefit the organisation and increase their sense of satisfaction with what they are doing. Team based points systems for good performance and regular rewards for excellent care. These points systems can then be used to promote competition between teams which should raise the level of care. Have a monthly leader board and reward the best team with a day at a spa or something. These changes may hark back to ideas that are out of favour now with the increased desires for measured ‘efficiency’, but I believe that these suggestions would hugely increase staff well being, which would hopefully improve their attitudes towards the organisation they work for and would hence make them happier and less stressed when they are caring for patients. If you have any other suggestions for improving staff wellbeing please do leave comments. The NHS is enormous and has a huge variety. It would be fascinating to survey as many parts of it as possible and see how many places have these services available for the staff already. Please feel free to contact me if you know of any study like this or if you are keen of setting up a study like this with me.  
jacob matthews
about 7 years ago
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Physiology, Medullary Cycling and Amonium Trapping: Acid Base Tutorial, University of Connecticut Health Center

After ammoniagenesis, ammonium is taken up into the medullary interstitium via a process called medullary recycling. It is then pumped back into the tubular fluid at the level of the collecting duct, where it undergoes what is called ammonium trapping after which it is excreted.  
fitsweb.uchc.edu
over 6 years ago
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Arthritis-India

Pain at multiple body areas is a common problem affecting 7-13% of western population. Most studies indicate a female preponderance and association with psychological distress in these cases. Pain is usually present for many years. Generalised pain needs to be distinguished from various forms of arthritis. Pain in these conditions does not have exact localization and usually not restricted to joints. Patients may complain of pain in other areas such as bones, muscles and back. Although severity of chronic generalised or widespread pain can vary from one individual to another it does affect physical functions and emotions leading to diminished quality of life. Chronic widespread pain can occur in children too. These conditions have direct societal impact in addition to direct and indirect medical costs.Causes of Generalised PainVarious conditions can cause generalised pain. Some of these are listed below:  
arthritis-india.com
over 6 years ago
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Handover: What are your tips? - My Working Life - Blog - My working life - BMA Communities

Regardless of what specialty you practice, what setting you’re in, where in the UK you work all doctors routinely perform handovers.How do you handover?  How were you taught?  And what’s influenced your practice?Handover is the single most important duty that a junior doctor will routinely perform. It will directly affect the care your patient receives when you are not present to provide it; not there to implement the decisions you and your team had already planned.Think back to your time at medical school, whether you were taught the didactic way, the integrated way or the PBL way, how much focus was really put on handover? How many opportunities were you given to practise your handover?A succinct and clearly communicated handover will ensure your patient receives tailored care on time – the same care out of hours as they would have had in hours.While you can talk about and study the handover process at medical school, you will only master the art once you are experiencing the handover process; more importantly, when you receive the handover.I can still recall my first handover following graduation. It was in a Tertiary Paediatric Hospital. We were in a small room in a closed ward. It was the Friday of induction week and I’d only recently been told I was on-call. I was armed with a black pen, a piece of plain paper and my mind was racing with all the possible scenarios that I could be given. Ten minutes into handover and our bleeps went, “BEEP, BEEP, BEEP! This is a cardiac arrest call. Cardiac arrest team to the main car park.” The car park was at the other end of the hospital, a good seven-minute run away. That’s all I remember; that and being out of breath by the time we got back to the handover room...Now I’m armed with multiple pens (in case one runs out), I have a highlighter to help the most important jobs stand out (when you’re given pages of patients, most of whom won’t require out-of-hours care; highlighting the most important bits helps) and my paper is squared. Our handover rooms are still tiny and whilst they’re meant to be bleep-free, they seldom are; I’m now armed with the right questions and a better model of prioritisation.1.  Be punctual. Whether you are providing the handover, or taking the handover, it is imperative you are on time. Unless the patient you are with needs your care as a matter of urgency, whatever you are doing can wait until after the handover. Your handover will affect the care of many patients and must take priority.   
communities.bma.org.uk
over 6 years ago
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New Alzheimer’s treatment fully restores memory function

Of the mice that received the treatment, 75 percent got their memories back.  
sciencealert.com
over 6 years ago
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If Saturated Fat Is Back, We’ll Need More Cardiologists

By Joel Kahn, MD  
medium.com
over 6 years ago
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Ebola crisis in Guinea 'has set back malaria fight' - BBC News

The Ebola epidemic in Guinea that began early last year has set back the country's fight against malaria, say experts.  
bbc.co.uk
over 6 years ago