scholarly journals Setting New Standards for Acute Care

2007 ◽  
Vol 6 (2) ◽  
pp. 85-86
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Acute Care ◽  
Inaugural Address ◽  
International Meeting ◽  
Long Distance ◽  
Acute Medicine ◽  
The Past ◽  
Conference Centre ◽  
Incoming President

The Scottish Exhibition and Conference Centre provided the venue for the first truly International meeting of the Society for Acute Medicine in early October. Almost 600 delegates were treated to some unseasonal Glasgow sunshine and traditional Scottish hospitality, as they enjoyed the varied programme put together by Mike Jones, Derek Bell and Liz Myers. The long distance that the Society has travelled in the past 7 years to reach this size was emphasised repeatedly over the two days; in his inaugural address to the society as incoming President, Dr Rhid Dowdle told us that SAM is now playing in a much bigger league than ever before, but cautioned that the speciality still has a way to go to reach the ‘top division’. Some of the highlights of the meeting are summarised below, but for those delegates who did not make it to the event most of the presentations are now available on the SAM website (www.acutemedicine.org.uk)

scholarly journals Selected Abstracts from the Society for Acute Medicine and Royal College of Physicians of Edinburgh Autumn International Meeting 2016

2016 ◽  
Vol 15 (4) ◽  
pp. 197-205
Keyword(s):  
Peer Review ◽  
Royal College ◽  
International Meeting ◽  
Acute Medicine ◽  
International Conference ◽  
Conference Centre

The Autumn meeting of the Society for Acute Medicine in 2016 was co-hosted with the Royal College of Physicians of Edinburgh and was held in the prestigious surroundings of the Edinburgh International Conference Centre. As usual a large number of abstracts were received and over 150 of these were selected for display as posters following peer review. Those ranked most highly were also presented orally, and the abstracts of these are published here. We have also published the abstracts of the posters which were awarded ‘highly commended’ rosettes during the meeting.

COMBINING ORAL TRADITIONS AND BAYESIAN CHRONOLOGICAL MODELING TO UNDERSTAND VILLAGE DEVELOPMENT IN THE GULF OF PAPUA (PAPUA NEW GUINEA)

Radiocarbon ◽  
2021 ◽  
pp. 1-21
Author(s):  
Chris Urwin ◽  
Quan Hua ◽  
Henry Arifeae
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Oral Traditions ◽  
Long Distance ◽  
Spatial History ◽  
The Past ◽  
History Of ◽  
Gulf Of Papua ◽  
The Village

ABSTRACT When European colonists arrived in the late 19th century, large villages dotted the coastline of the Gulf of Papua (southern Papua New Guinea). These central places sustained long-distance exchange and decade-spanning ceremonial cycles. Besides ethnohistoric records, little is known of the villages’ antiquity, spatiality, or development. Here we combine oral traditional and 14C chronological evidence to investigate the spatial history of two ancestral village sites in Orokolo Bay: Popo and Mirimua Mapoe. A Bayesian model composed of 35 14C assays from seven excavations, alongside the oral traditional accounts, demonstrates that people lived at Popo from 765–575 cal BP until 220–40 cal BP, at which time they moved southwards to Mirimua Mapoe. The village of Popo spanned ca. 34 ha and was composed of various estates, each occupied by a different tribe. Through time, the inhabitants of Popo transformed (e.g., expanded, contracted, and shifted) the village to manage social and ceremonial priorities, long-distance exchange opportunities and changing marine environments. Ours is a crucial case study of how oral traditional ways of understanding the past interrelate with the information generated by Bayesian 14C analyses. We conclude by reflecting on the limitations, strengths, and uncertainties inherent to these forms of chronological knowledge.

Editorial

2016 ◽  
Vol 15 (1) ◽  
pp. 2-2
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
The Netherlands ◽  
Editorial Team ◽  
Patient Specific ◽  
Service Improvement ◽  
Single Individual ◽  
National Goal ◽  
Acute Medicine ◽  
North West ◽  
The Past

Clinicians working in acute medicine will be familiar with change. The speciality and the environment we work in has changed continually over the past 15 years – I often reflect that no two years have been the same since I started working in the field back in 1999. Change is important, in order to achieve best practice, but sustaining such improvements can be an enormous challenge. The regular turnover of medical staff, local management restructuring and the constantly shifting National goal posts often conspire against us. It is easy for ‘changefatigue’ to set in. Submissions to this journal often describe local audits and service improvement projects which have raised standards: a low baseline may result in a statistically significant improvement from a relatively small intervention – often an education programme or poster campaign to raise awareness of the problem. However, what happens next is far more important: can the improvement be sustained when the key driver behind the project – the enthusiast – moves on, after their 4 month block of acute medicine comes to an end? One year on, we are often back where we started. Two articles in this edition appear to have achieved the Holy Grail of sustainability. In the paper by Joanne Botten from Musgrove Park, door to antibiotic time was improved for patients with neutopaenic sepsis by introducing a system whereby the antibiotics could be administered without waiting for a prescription to be written. The combination of a neutropaenic sepsis alert card and a patient-specific direction empowered the nurses and patients to ensure administration within an hour of arrival in over 90% of cases, a figure which has been sustained for over a year. Sustainable change is often facilitated by modifications in paperwork, but crucially the project’s success was not reliant on a single individual. The value of engaging with the wider team is also shown in Gary Misselbook’s paper describing sustained improvement in the layout and utility of an AMU procedure room. The authors describe how repeated attempts by different registrars had failed to achieve more than temporary reorganisation; the change was only sustained when nursing, infection control and administrative staff became involved in the process. The multiprofessional nature of the AMU is one of its greatest assets – we would all do well to remember this when instigating change. On a similar note, observant readers may have noticed some changes to the editorial board of this journal – I am delighted to welcome Dr Tim Cooksley, acute physician from Manchester and Dr Prabath Nanayakkara from the VUMC in the Netherlands. Tim came through the acute medicine training programme in the North West and his role in the acute oncology service at the Christie Hospital as well as his active involvement in the SAMBA project over recent years brings an important perspective to the editorial team. Prabath has been heavily involved with the development of acute medicine in the Netherlands and co-hosted the successful SAMSTERDAM meeting in 2014. His international perspective will be welcome as we attempt to extend the reach of Acute Medicine to our European neighbours over the coming years. I am very grateful to Nik Patel, Mark Jackson and Ashwin Pinto for their help and support during the past decade and wish them well for the future.

Abstracts from ‘Highly Commended’ Posters at the Society for Acute Medicine Autumn International Conference

2014 ◽  
Vol 13 (1) ◽  
pp. 16-22
Keyword(s):  
Acute Medicine ◽  
International Conference ◽  
Conference Centre

Scottish Exhibition and Conference Centre, Glasgow; 3-4th October 2013 A number of posters at the 7th International Conference of the Society for Acute Medicine were awarded ‘highly commended’ certificates by a panel of judges. The abstract text from these posters published here. The posters themselves can be accessed via the Society for Acute Medicine website: www.acutemedicine.org.uk

Acute Medicine Trainee Update

2011 ◽  
Vol 10 (3) ◽  
pp. 149-149
Author(s):  
Amy Daniel ◽  
◽  
Alice Miller ◽  
Keyword(s):  
Palliative Care ◽  
Medical Ethics ◽  
Advisory Committee ◽  
Skill Training ◽  
Skills Training ◽  
Training Programme ◽  
Acute Medicine ◽  
The Past ◽  
Training Programme Director ◽  
The Cost

We have been aware for a while that there are disparities in specialist skill provision both between and within deaneries – and the SAC is working hard to identify problems in this area. More recently, the issue of funding for specialist skills has been raised. It seems that some deaneries are happy and able to contribute towards the cost of training in a particular skill, while others are not; in at least one deanery, part-funding has now been withdrawn, leaving trainees to cover the entire cost of their chosen skills training. As specialist skill training is now a mandatory part of the Acute Medicine curriculum, we need to find a way to eliminate disparity both between different deaneries and between different skills. However, there is no easy solution, and for the time being, trainees will have to factor in the potential financial implications of a particular skill when they are considering their options. On a brighter note, the list of recognised specialist skills has increased over the past year. Palliative Care has been authorised as a suitable skill, and Medical Ethics and Law will soon also be added to the list. If you would like to propose a skill that is not currently listed in the Acute Medicine curriculum, you should discuss it with your training programme director, who can bring the proposal to the Acute Medicine Specialty Advisory Committee (SAC).

Editorial

2006 ◽  
Vol 5 (1) ◽  
Author(s):  
Chris Roseveare
Keyword(s):  
Psoas Abscess ◽  
Special Section ◽  
Hospital Medicine ◽  
Regular Feature ◽  
Acute Medicine ◽  
The Past ◽  
Hospital Referral ◽  
Working Practices ◽  
The Impact ◽  
Rule Out

Few will deny that the past 6 months have been particularly challenging for all clinicians working in hospital medicine. The pressures of ward closures, which many acute hospitals have faced recently, have undoubtedly increased the ‘bottle-neck’ effect at the front door. Any ‘slack’ which might have existed in the past has now disappeared – 82% occupancy, which was once touted as the Holy Grail of bed-crisis prevention now seems a forlorn hope. One of the Government’s solutions is that chronic disease will be managed without admission to hospital. In reality, this will require dramatic changes in the attitudes of patients, carers and general practitioners and will not happen quickly. The impact of any pre-emptive reduction in capacity will be felt long before any such changes take effect. In the meantime it will up to those of us working in the AMU to ‘sort-out’ and ‘turf-out’, where appropriate. Looking on the bright side, at least when the next round of consultant redundancies is announced we should have little difficulty in justifying our existence…. The request to ‘rule-out serious pathology’ is a frequent justification for hospital referral. When the problem is that of a sudden onset of headache the need to rule-out subarachnoid haemorrhage becomes paramount. Most readers will not make the mistake I made once as an SHO, in assuming that negative CT brain scanning is adequate in this context. However, CSF analysis is not always straightforward. Stephen Hill and Ashwin Pinto’s excellent review of this subject will help unravel some of the complexities in this area. Hopefully the reviews of the acute management of chronic liver disease, psoas abscess and sickle cell disease will also be helpful in your day-to-day working practices. I would also draw your attention to the postcard, which Dr Snape has kindly submitted from a collection donated to him by a patient. Referring to the 1918 Avian Inf luenza outbreak the postcard’s author provides a chilling reminder of the impact of this pandemic. If ‘rule-out avian ‘f lu’ becomes a reason for referral to hospital in the future, we will hopefully be well prepared. Finally in a slight change to the previous format there is now a special section of the journal relating to the Society for Acute Medicine. I am aware that a large proportion of readers are members of the society and this needs to be ref lected in the journal’s content. The ‘Society Pages’ will become a regular feature in the journal, hopefully providing readers with useful information and updates on developments within Acute Medicine. In this edition I have included the abstracts from the Free Paper session at the recent meeting in Hull, along with a summary of the meeting and programme for the next meeting in the Royal College of Physicians. Submissions for this section could include summaries of working practices within different acute medicine units around the country, as well as experiences of trainees undertaking the new acute medicine training programmes. All would be gratefully received.

scholarly journals Distinguishing technology from biology: a critical review of the use of GPS telemetry data in ecology

2010 ◽  
Vol 365 (1550) ◽  
pp. 2303-2312 ◽  
Author(s):  
Mark Hebblewhite ◽  
Daniel T. Haydon
Keyword(s):  
Animal Ecology ◽  
Animal Movement ◽  
Gps Telemetry ◽  
Long Distance ◽  
Location Data ◽  
The Past ◽  
Movement Data ◽  
Migratory Songbirds ◽  
Spatio Temporal ◽  
Gps Devices

In the past decade, ecologists have witnessed vast improvements in our ability to collect animal movement data through animal-borne technology, such as through GPS or ARGOS systems. However, more data does not necessarily yield greater knowledge in understanding animal ecology and conservation. In this paper, we provide a review of the major benefits, problems and potential misuses of GPS/Argos technology to animal ecology and conservation. Benefits are obvious, and include the ability to collect fine-scale spatio-temporal location data on many previously impossible to study animals, such as ocean-going fish, migratory songbirds and long-distance migratory mammals. These benefits come with significant problems, however, imposed by frequent collar failures and high cost, which often results in weaker study design, reduced sample sizes and poorer statistical inference. In addition, we see the divorcing of biologists from a field-based understanding of animal ecology to be a growing problem. Despite these difficulties, GPS devices have provided significant benefits, particularly in the conservation and ecology of wide-ranging species. We conclude by offering suggestions for ecologists on which kinds of ecological questions would currently benefit the most from GPS/Argos technology, and where the technology has been potentially misused. Significant conceptual challenges remain, however, including the links between movement and behaviour, and movement and population dynamics.

The Functional Movement Screen test as a tool for functional evaluation of movement patterns in long-distance runners

2019 ◽  
Vol 29 (88) ◽  
pp. 85-96
Author(s):  
Iwona Sulowska-Daszyk ◽  
Agnieszka Skiba
Keyword(s):  
Movement Patterns ◽  
Screen Test ◽  
Functional Evaluation ◽  
Functional Movement Screen ◽  
Distance Runners ◽  
Long Distance ◽  
Functional Movement ◽  
The Past ◽  
History Of ◽  
Quality Of Movement

Aim: The aim of this study was to evaluate the relationship between the results achieved in the Functional Movement Screen test and various aspects of training as well as injury history in long-distance runners. Basic procedures: The study involved 30 long-distance runners aged 20 to 45 years, training regularly from two to seven days a week and covering a total distance from 10 to 100 km. The subjects completed a questionnaire containing queries about training and past injuries. The Functional Movement Screen test was used to assess the quality of movement patterns. Results: The mean total score in the FMS test was 16.03 points. Results within the range from 18 to 21 points were achieved by 6 subjects, 3 of the subjects suffering injuries in the past. Results in the range from 14 to 17 points were obtained by22 subjects, 14 subjects having a history of injury. Ascore below 14 points was reachedby 2 subjects, both of them suffering injuries in the past. Conclusions: The results of this study indicate that a lower FMS score is associated with a greater number of injuries in the past. Warming up before training is a good way to prevent injury, while stretching after training does not seem reduce the incidence of injury.

Optimization of physical fitness of rowers-academics

2021 ◽  
pp. 131-134
Author(s):  
O. Shalar ◽  
Y. Strikalenko ◽  
V. Huzar ◽  
V. Homenko ◽  
R. Andreeva
Keyword(s):  
Physical Fitness ◽  
Basic Training ◽  
Long Distance ◽  
National Team ◽  
The Past ◽  
Preparatory Period ◽  
Long Distance Running ◽  
Rowing Ergometer ◽  
Promising Area ◽  
Sports Skills

The article reveals and analyzes the content of physical training of rowers-academics of two schools of higher sportsmanship: Kherson and Dnipro in the preparatory period. The training programs included exercises in gyms with different weights, namely lying down, squats with a barbell; rowing on an ergometer; long distance running. The magnitude of the training load, the intensity of training was determined by coaches depending on the condition of the athlete. Changes in the indicators of physical fitness of these athletes were studied. It is proved that after the training camp in the preparatory period of training rowers-academics the result on the rowing ergometer Concept 2 increased and the growth rate in the national team of Dnipro SHVSM was 1.2%, and in the national team of Kherson SHVSM 0.7%. According to the test, the thrust of the barbell lying - in the national team of the Dnieper SHVSM 11.7%, and in the national team of the Kherson SHVSM 27.8%. A promising area of further work is to study the features of technical training of rowers-academics. The need for targeted training in the training process from the stage of preliminary basic training to higher sports skills requires finding the best options for training planning in each age group and for different periods and stages of the annual cycle. The experience of the past years shows that the process of development of sports results in rowing is organically connected with the improvement of the physical fitness of the rower, but the reserves in this direction are not yet exhausted.

Response to Letter to the editor: Acute Medicine Journal

2020 ◽  
Vol 19 (1) ◽  
pp. 57-57
Author(s):  
Ben Chadwick ◽  
◽  
Nick Murch ◽  
Anika Wijewardane ◽  
◽  
...  
Keyword(s):  
Internal Medicine ◽  
Acute Care ◽  
Working Group ◽  
Point Of Care ◽  
Early Years ◽  
Point Of Care Ultrasound ◽  
Acute Medicine ◽  
Front Door ◽  
Medicine Journal ◽  
Wide Range

Editor- Thank you for giving us the opportunity to respond to the letter received regarding the Joint Royal College of Physicians Training Board (JRCPTB) curriculum for Acute Internal Medicine (AIM) that has previously been circulated for comment and consideration of implementation in August 2022. Dr Williamson is correct in asserting that the proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It does aim to produce a workforce that reflects the current trends of increasing patient attendances to both primary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with co-morbidities and recognise when specialty input is required in a variety of settings, including ambulatory and critical care. Contrary to the situation described in the correspondence, the new curriculum does not move away from each trainee being required to develop a specialist skill, such as medical education, management, stroke medicine or focused echocardiography. Trainees will still need to acquire competency in a specialist skill for their final 36 months of their training programme, usually after they have completed their Point of Care Ultrasound (POCUS) certification. The thinking behind introducing mandatory POCUS in the curriculum is that: POCUS is in the proposed curricula for intensive care medicine, respiratory medicine and emergency medicine, therefore we feel that in order to recruit the best trainees it is imperative POCUS training is offered as standard As evidenced by the trainee surveys, they often do not get allocated time to develop their specialist skill, especially in the early years of Higher Specialty Training before they often have decided on a particular skill. The introduction of mandatory POCUS training should legtimise time off the ward to obtain this skill early in training. POCUS is becoming more and more standardised in 21st Century acute care alongside the reducing costs of Ultrasound probe e.g. Philips Lumify and Butterfly iQ which are compatible with smart phones POCUS has been heralded as the fifth pillar of examination (observation, palpation, percussion, auscultation, insonation)1 The proposed curriculum therefore facilitates trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This will also enable trainees to have time away from the ‘front door’ high intensity acute care. Mandatory POCUS will continue to set AIM training apart from other physician training programmes and continue to attract high quality trainees to apply to the specialty. Formal feedback seen at the SAC meeting in October 2019 to the draft curriculum (personal correspondence from JRCPTB) showed a positive response from nine individuals, an ambivalent one from two people, and only two against the introduction of formal POCUS training in the curriculum. Point of Care Ultrasound will likely be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country. Concerns regarding supervision are being addressed by the POCUS working group, in anticipation of the lead in period of well over two years. It is anticipated that most trainees can achieve POCUS sign off (e.g. Focused Acute Medical Ultrasound) in 6 to 12 months (personal correspondence Nick Smallwood from POCUS working group). With ongoing concerns regarding recruitment and retention in Acute Internal Medicine we agree strongly that with POCUS inclusion, we have a further selling point for AIM training.

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