The Use of Telemetry Monitoring Among General Medicine Patients

Objective: To determine why and when general medicine non-ICU patients are upgraded from a non-telemetry level of care to telemetry monitoring at Thomas Jefferson University Hospital (TJUH). Comparison of the reasons for initiation of continuous ECG monitoring with the AHA and ACC guidelines would provide a greater understanding of the applicability of these recommendations to non-ICU general medicine patients. This information can provide guidance to identify areas of intervention to decrease inappropriate and/or overutilization of telemetry. The ultimate goal is to identify general medicine patients who are likely to benefit from continuous ECG monitoring, without negatively affecting clinical outcomes for those who do not receive cardiac monitoring.https://jdc.jefferson.edu/patientsafetyposters/1025/thumbnail.jp

ECG Wave-Maven: An Internet-based Electrocardiography Self-Assessment Program for Students and Clinicians

Purpose: To create a multimedia internet-based ECG teaching tool, with the ability to rapidly incorporate new clinical cases. Method: We created ECG Wave-Maven (http://ecg.bidmc.harvard.edu), a novel teaching tool with a direct link to an institution-wide clinical repository. We analyzed usage data from the web between December, 2000 and May 2002. Results: In 17 months, there have been 4105 distinct uses of the program. A majority of users are physicians or medical students (2605, 63%), and almost half report use as an educational tool. Conclusions: The internet offers an opportunity to provide easily-expandable, open access resources for ECG pedagogy which may be used to complement traditional methods of instructio

Endovascular Cure of a Locked-In Patient

We report the case of a 60 year-old right-handed gentleman who became acutely “Locked-In” several days after a lower extremity orthopedic procedure. He underwent emergent endovascular treatment and had complete resolution of his neurologic findings except for mild dysarthria and dysphagia. Endovascular intervention for posterior circulation thrombosis is highly effective when patients are treated within 24 hours

William Edwards Ladd, M.D. (1880-1967): the description of his bands.

In the early 20th century, an established surgical specialty catering to pediatric surgery did not exist, and pediatric surgical ailments were operated on by general surgeons. With his devotion to childhood diseases and his unique thinking in surgical development, William E. Ladd would become a leading figure in America by pioneering the field of pediatric surgery

What differentiates professional poker players from recreational poker players? A qualitative interview study

The popularity of poker (and in particular online poker) has increasingly grown worldwide in recent years. Some of the factors that may explain this increased popularity include: (i) an increasing number of celebrities endorsing and playing poker, (ii) an increased number of televised poker tournaments, (iii) 24/7 access of poker via the internet, and (iv) the low stakes needed to play online poker. This increase in the popularity of poker has led to the increased incidence of the ‘professional poker player’. However, very little empirical research has been carried out into this relatively new group of gamblers. This research comprised a grounded theory study involving the analysis of data from three professional poker players, one semi-professional poker player and five recreational poker players. Results showed that all players believed that poker was a game of skill. The central theme as to what distinguishes professional poker players from recreational players was that professional poker players were much more disciplined in their gambling behaviour. They treated their poker playing as work, and as such were more likely to be logical and controlled in their behaviour, took less risks, and were less likely to chase losses. Recreational players were more likely to engage in chasing behaviour, showed signs of lack of control, took more risks, and engaged in gambling while under the influence of alcohol or drugs. Also of importance was the number of games and time spent playing online. Recreational players only played one or two games at a time, whereas professional poker players were much more likely to engage in multitable poker online, and played longer sessions, thus increasing the potential amount of winnings. Playing poker for a living is very possible for a minority of players but it takes a combination of talent, dedication, patience, discipline and disposition to succeed

Motivating and inhibiting factors in online gambling behaviour: a grounded theory study

To date, there has been very little empirical research examining why people gamble online or – just as importantly – why they do not gamble online. A grounded theory study examining the motivating and inhibiting factors in online gambling was carried out. The sample comprised 15 online gamblers, 14 offline gamblers, and 11 non-gamblers, and resulted in the identification of one major theme as to why participants were motivated to gamble online (i.e., greater opportunity to gamble) and four sub-themes (i.e., convenience, value for money, the greater variety of games, and anonymity). The main reason that inhibited online gambling was that the authenticity of gambling was reduced when gambling online. Four further sub-themes were identified as inhibitors of online gambling (i.e., the reduced realism, the asocial nature of the internet, the use of electronic money, and concerns about the safety of online gambling websites). Results also indicated that the participants’ perception was that online gambling was more addictive than offline gambling and that online gambling would exacerbate gambling problems in society

Watch Your Back! How the Back Pain Industry is Costing Us More and Giving Us Less - And What You Can Do to Inform and Empower Yourself in Seeking Treatment

[Excerpt] This book considers what we know about treatments for back pain and asks a number of critical questions. Are some of the most popular treatments really effective? Do they “cure” or even improve the problems they claim to address? If some back pain treatments are ineffective or even harmful, why do patients clamor for them and doctors provide them? Who benefits from the vast back pain industry that’s developed over the past thirty years? Is it patients? Or the doctors, hospitals, and man­ufacturers that produce the technology of back pain therapy? What does all this say about our medical system? Or our efforts to enhance quality, improve safety, and reduce health care costs? How can patients maneuver to help themselves rather than help the medical industry? Will efforts to measure patient satisfaction help deliver safer and more effective treatments or encourage the opposite? In answering these questions, this book does more than describe and analyze the back business. It also explores the complex ways that doctors interact with patients, drug companies, and medical device makers. The results can inadvertently lead to treatments that are inef­fective or even harmful

Gambling on the Internet: motivating and inhibiting factors

Gambling operators can certainly benefit from knowing who their customers are, and why they choose to gamble. Professor Mark Griffiths and Abby McCormack, of Nottingham Trent University, discuss different socio-cultural player profiles, and assess how offline and online gambling platforms compare in this context