The latest medical research on Retrieval Medicine

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about retrieval medicine gathered by our medical AI research bot.

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Understanding rural pharmacists' perspectives: lived experiences and insights associated with rural recruitment and retention.

Rural and Remote Health

Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities.

The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention.

The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns.

Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.

Tranexamic acid versus oxytocin for primary postpartum Haemorrhage in the out-of-hospital setting: A systematic review with implications for rural practice.

Australian Journal of Rural Health

Primary postpartum haemorrhage causes approximately 25% of global maternal deaths and accounts for significant maternal morbidity. While high certainty evidence demonstrates that tranexamic acid reduces comparative blood loss in postpartum haemorrhage in hospital settings, limited data exist on the specific pharmacological management of this condition in out-of-hospital settings, and the implications for rural communities.

To determine the efficacy of oxytocin compared to tranexamic acid in women suffering postpartum haemorrhage in the out-of-hospital environment.

A systematic review comparing evidence containing patients with postpartum haemorrhage in the out-of-hospital and/or rural setting, in which oxytocin/tranexamic acid were used. Outcome measures were comparative blood loss/haemorrhagic shock, the need for further interventions and maternal/neonatal morbidity/mortality.

No randomised control trials have been conducted in an out-of-hospital environment in relation to oxytocin/tranexamic acid. In this setting, there is no difference in outcome measures when using oxytocin compared to no intervention, or oxytocin compared to standard care. Data are lacking on the effect of tranexamic acid on the same outcome measures.

There is no difference in blood loss, neonatal or maternal mortality or morbidity, or need for further interventions, when using oxytocin or TXA compared to no intervention, or compared to standard care, for PPH. Further studies are needed on the efficacy of these drugs, and alternate or co-drug therapies, for PPH in the out-of-hospital environment and rural clinical practice.

Examining online international health professions education: a mixed methods review of barriers, facilitators, and early outcomes★.

Journal of Extra-Corporeal Technology

Access to quality healthcare education across the world is disproportionate. This study explores the potential for Cardiovascular Perfusion education to be delivered online to reach international students.

Exploratory mixed methods were used to identify the barriers, facilitators, and early outcomes of online international health professions education.

Qualitative analysis yielded four primary and nine subthemes. Multiple interventions were implemented in the planning of a novel online international Extracorporeal Science (ECS) program based on these themes. Quantitative data from the first semester of the new ECS program was collected along with data from the traditional entry-level program and historic data from previous entry-level cohorts. No significant correlations or differences were found between students. Student satisfaction surveys were determined to be equivalent for each group. Mixed data analysis revealed exceptional student satisfaction in areas where qualitative feedback was incorporated into the program design.

Online international education may be a viable option in the health professions. Barriers and facilitators to this mode of education were identified and utilized in designing one such program. Early outcomes from the novel ECS program reveal that student performance and satisfaction are equivalent to those of a traditional in-person training program.

Preliminary report of extracorporeal blood purification therapy in patients receiving LVAD: Cytosorb or Jafron HA330.

Journal of Extra-Corporeal Technology

Left ventricular assist device (LVAD) candidates are at increased risk of immune dysregulation and infectious complications. To attenuate the elevated proinflammatory cytokine levels and associated adverse clinical outcomes, it has been postulated that extracorporeal blood purification could improve the overall survival rate and morbidity of patients undergoing LVAD implantation.

We retrospectively reviewed prospectively collected data of 15 patients who underwent LVAD implantation at our center between January 2021 and March 2022. Of these, 15 (100%) who received HeartMate 3™ (St. Jude Medical, Abbott, MN, USA) device were eligible. Intraoperatively, patients were single randomized 1:1:1 to three groups: group 1, patients who received Cytosorb therapy (n = 5; installed in the CPB circuit); group 2, patients who received Jafron HA330 (n = 5; installed in the CPB circuit); and control group 3, patients who did not receive filter (n = 5; usual care, neither Cytosorb nor Jafron during CPB). Baseline patient characteristics and intraoperative data were compared between the groups. Blood sample analyses were performed to assess the levels of inflammatory markers (IL-1, 6, 8; CRP, Leukocyte, Lactate, PCT, NT-proBNP, TNF-α) in both preoperative and postoperative data.

Baseline patient characteristics were similar in all three groups. We found that IL1α; IL 6; IL8; Lactatedehydrogenase, PCT, pro-BNP, CRP; Leukocyte, and TNFα levels significantly increased with LVAD implantation and that neither Cytosorb nor Jafron influenced this response. In-hospital mortality and overall survival during follow-up were similar among the groups.

Our preliminary results showed that hemoadsorption therapy using Cytosorb or Jafron hemoadsorption (HA) 330 may not be clinically beneficial for patients with advanced heart failure undergoing LVAD implantation. Large prospective studies are needed to evaluate the potential role of HA therapy in improving outcomes in patients undergoing LVAD implantation.

Perfusion techniques for an 800 g premature neonate undergoing Arterial Switch Procedure for Transposition of the Great Arteries★.

Journal of Extra-Corporeal Technology

Early cardiac surgery in neonates and infants with congenital heart disease has been performed since the middle to late years of the twentieth cent...

Improving ECMO therapy: Monitoring oxygenator functionality and identifying key indicators, factors, and considerations for changeout.

Journal of Extra-Corporeal Technology

The optimal timing for extracorporeal membrane oxygenation (ECMO) circuit change-out is crucial for the successful management of patients with severe cardiopulmonary failure. This comprehensive review examines the various factors that influence the timing of oxygenator replacement in the ECMO circuit. By considering these factors, clinicians can make informed decisions to ensure timely and effective change-out, enhancing patient outcomes and optimizing the delivery of ECMO therapy.

A thorough search of relevant studies on ECMO circuits and oxygenator change-out was conducted using multiple scholarly databases and relevant keywords. Studies published between 2017 and 2023 were included, resulting in 40 studies that met the inclusion criteria.

In conclusion, managing circuit change-outs in ECMO therapy requires considering factors such as fibrinogen levels, blood gases, plasma-free hemoglobin, D-dimers, platelet function, flows, pressures, and anticoagulation strategy. Monitoring these parameters allows for early detection of issues, timely interventions, and optimized ECMO therapy. Standardized protocols, personalized anticoagulation approaches, and non-invasive monitoring techniques can improve the safety and effectiveness of circuit change-outs. Further research and collaboration are needed to advance ECMO management and enhance patient outcomes.

Advocating for an open communication culture in perfusion and cardiothoracic community: a call to action.

Journal of Extra-Corporeal Technology

This article advocates for an open communication culture in the perfusion and cardiothoracic community to enhance patient safety during surgery. Al...

Dhikr and Qur'an Recitation Therapy: An Idea to Recover the Mental Health of Families of the Death Victims of Mount Marapi Eruption in West Sumatra, Indonesia.

Prehosp Disaster Med

Volcanic eruption is one of the most common disasters in Indonesia. One of the most fatal volcanic eruptions in Indonesia in 2023 was the eruption of Mount Marapi in West Sumatra. This caused a psychological impact on the survivors and families of the victims who died.

Psychological interventions are usually only provided to survivors. It is very rare to find psychosocial assistance provided to the families of victims who died, even though they also experience acute and prolonged mental health disorders, such as trauma and even depression. So, we offer the idea of remembrance therapy and reading the Qur'an to restore the mental health of the families of the deceased victims.

Dhikr and Qur'an recitation therapy fosters sincerity, patience, and self-acceptance so as to restore mental health in the families of the victims of the Mount Marapi eruption. The therapy serves as a calming factor for the soul because it contains various wisdoms for the calamities experienced. The whole series of therapy is closed with prayer as a form of surrendering the soul to God.

Interorganizational Knowledge Transfer in Mass Gatherings: Exploring the Health and Safety Stakeholders' Perceptions Participating in the Athens Marathon.

Prehosp Disaster Med

Mass gatherings (MGs) usually represent significant challenges for the public health and safety sector of the host cities. Organizing a safe and successful mass event highly depends on the effective collaboration among different public and private organizations. It is necessary to establish successful coordination to ensure that all the key stakeholders understand their respective roles and responsibilities. The inconsistency between the variety of participating agencies because of their different culture can result in delays in decision making. Interorganizational knowledge transfer can improve the success of the event; however, knowledge transfer among professionals and agencies in MGs is not well-documented.

This study used the 2018 Athens Marathon as the empirical setting to examine how interorganizational knowledge transfer was perceived among the multiple public health and safety professionals during the planning stage of the event.

Data comprised 18 semi-structured, in-depth interviews with key informants, direct observations of meetings, and documentary analysis. Open coding and thematic analysis were used to analyze the data.

Findings indicated that sharing the acquired knowledge was a necessary and challenging step to create an enabling collaborative environment among interacting organizations. Experiential learning was identified as a significant factor, which helped promote joint understanding and partnership work. Informal interpersonal exchanges and formal knowledge transfer activities facilitated knowledge sharing across organizational boundaries, helping to break down silos.

Interorganizational knowledge transfer is a necessary step to achieve joint understanding and create an environment where interaction among agencies can be more effective. The study findings can be beneficial for organizers of marathons and other mass sporting events to support valuable interorganizational collaboration and conduct a safe event.

Learning process of implementing a cutaneous leishmaniasis capacity-building program, using an innovative pedagogy for rural populations in Colombia.

Rural and Remote Health

Participatory approaches to health often link capacity building as an indispensable process for strengthening the social capital of communities, in order to develop empowerment processes that lead to social transformation at the local level. In Pueblo Rico (Colombia), a capacity-building program in cutaneous leishmaniasis and social skills for community work was implemented with school students, health workers and local leaders. This article seeks to evaluate the implementation, results, and impact of that program.

Primary data were collected through participant observation, questioners, the development of artistic products, and a focus group. Qualitative data were coded and analyzed through thematic analysis, and the quantitative data were quantitively coded and analyzed.

The capacity-building program had positive results in terms of the three aspects evaluated: the pedagogical model's implementation, the learning process, and the impact of the program. Three key elements that contributed to the success of the program were identified: the application of the principles of meaningful learning as a guide for the pedagogical model, the use of Social Innovation in Health case studies to broaden participant's perspective, and the creation of artistic products as facilitators for the appropriation of knowledge.

Participatory pedagogical models adequate to the context and its participants allow the implementation of effective training programs that develop capacities within the communities. To achieve a significant impact, it is necessary to ensure the continuity and long-term sustainability of capacity building through transfer of knowledge with cooperation between health institutions and the community. In this way, the capacities developed by the community constitute a valuable social capital for achieving transformations within and outside the health field.

Scapular fractures: A regional and rural perspective.

Australian Journal of Rural Health

Scapular fractures (SFs) have historically been associated with severe trauma and multiple injuries. Recent studies have demonstrated improved outcomes. However, SFs have never been studied from a strictly rural or Australian perspective.

The study's objective was to assess whether associations still exist between a fractured scapula and trauma scores, mortality rates, and other commonly associated injuries in a regional Australian trauma centre.

The study design examined prospectively collected data from a regional hospital between the years 2012 to 2021 presenting to the emergency department with traumatic SFs. Primary outcomes of interest were mortality rate, method of injury, ISS scores, and associated injuries.

One hundred and five patients had a SF. The median age was 49 with 93 (89%) being male. Most fractures were located in the body of the scapula (80%). The primary mechanism of injury was motorbike accidents (36%), falls (24%), and motor vehicle accidents (22%). Two patients died from their injuries (1.9%). Thirty-four percent demonstrated mild trauma scores, with 36% moderate, 28% severe, and 1.9% critical. Commonly observed associated injuries included chest wall fractures, vertebral fractures, thoracic injuries, brain injury, and abdominal trauma.

Given these results, a re-examination of whether SFs are a reliable marker of severe trauma should be considered.

Components of an Updated Disaster Medicine Curriculum Included in Emergency Medicine Residency and Emergency Medical Services Fellowship in the United States.

Prehosp Disaster Med

Disaster medicine (DM) is a unique field that has undergone significant development as disaster events become increasingly complicated to respond to. However, DM is not recognized by the American Board of Medical Specialties (ABMS) or Accreditation Committee of Graduate Medical Education (ACGME), and therefore lacks board certification. Furthermore, prior studies have shown that there is unique body of DM knowledge not being addressed in emergency medicine (EM) residency or Emergency Medical Services (EMS) fellowship, resulting in fundamental DM topics not being covered amongst graduate medical education (GME) programs most prepared to produce DM physicians. A recently published DM core curriculum addresses this knowledge gap and seeks to promote standardization of DM training.

The objective of this study is to analyze EM residency and EMS fellowship curricula for the inclusion of DM major curriculum topics and subtopics, using the most recently published DM core curriculum as a control.

Both EM residency and EMS fellowship curricula were analyzed for inclusion of DM curriculum topics and subtopics, using the DM curriculum recommendations published by Wexler, et al as a control. A major curriculum topic was deemed covered if at least one related subtopic was described in the curricula. The included and excluded DM topics and subtopics were analyzed using descriptive statistics.

While all the DM major curriculum topics were covered by either EM residency or EMS fellowship, EMS fellowship covered more major curriculum topics (14/15; 93%) than EM residency (12/15; 80%) and EMS fellowship covered more DM curriculum subtopics (58/153; 38%) than EM residency (24/153; 16%). Combined, EM residency and EMS fellowship covered 65 out of 153 (42%) of the DM curriculum subtopics.

Although this study finds that all the DM major curriculum topics will be covered in EM residency followed by EMS fellowship, over one-half of the subtopics are not covered by either program (16% and 38%, respectively) or both programs combined (42%). Increasingly relevant subtopics, such as climate change, droughts, and flooding, are amongst those not covered by either curriculum. Even amongst the DM topics included in GME curricula, an emphasis on themes such as mass treatment, preparedness, and mitigation is likely under-represented. Accreditation from ACGME for DM fellowship would further promote uniform implementation of the updated core curriculum and ensure optimal training of disaster-ready physicians.